Organization
MARY REGINA PHAM D.D.S., M.S. DENTAL CORPORATION
Active
Other names
Lollipop Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY REGINA PHAM DDS, MS (OWNER)
(714) 528-8252
Entity
Organization
Contact information
Practice address
1041 E YORBA LINDA BLVD, SUITE 206, PLACENTIA, CA 92870-3728
(714) 528-8252
Mailing address
1041 E YORBA LINDA BLVD, SUITE 206, PLACENTIA, CA 92870-3728
(714) 528-8252
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
60222
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
58404
CA
Other
Enumeration date
06/06/2012
Last updated
02/10/2022
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