Organization
NGO & PHAM DENTAL GROUP
Active
Other names
Grand Smile Care
Organization subpart
No
Provider details
NPI number
Authorized official
TUNG SON NGO DDS (OWNER)
(951) 549-0878
Entity
Organization
Contact information
Practice address
502 W GRAND BLVD, CORONA, CA 92882-2118
(951) 549-0878
(951) 496-4011
Mailing address
502 W GRAND BLVD, CORONA, CA 92882-2118
(951) 549-0878
(951) 496-4011
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689741159
—
CA
05
—
1831267053
—
CA
Enumeration date
03/30/2021
Last updated
03/30/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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