Individual
DR. DERIK QUAN PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1467 N WANDA RD STE 155, ORANGE, CA 92867-5328
(714) 538-6730
Mailing address
1467 N WANDA RD STE 155, ORANGE, CA 92867-5328
(714) 538-6730
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105165
CA
Other
Enumeration date
08/03/2020
Last updated
10/30/2023
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