Individual
THAI V PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
13127 KINGS LAKE DR, SUITE 101, GIBSONTON, FL 33534-3958
(813) 284-7958
Mailing address
13127 KINGS LAKE DR, SUITE 101, GIBSONTON, FL 33534-3958
(813) 284-7958
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN18558
FL
Other
Enumeration date
09/19/2009
Last updated
06/30/2022
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