Individual
LIENG T PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 350-4606
(970) 350-4626
Mailing address
1006 A ST, GREELEY, CO 80631-2021
(970) 352-0048
(970) 352-1120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7305
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02073054
—
CO
Enumeration date
08/21/2006
Last updated
02/04/2014
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