Organization
MICHAEL PHAM, DDS, MS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ANTHONY YTOAN PHAM DDS (PRESIDENT)
(707) 425-5666
Entity
Organization
Contact information
Practice address
2801 WATERMAN BLVD STE 290, FAIRFIELD, CA 94534-2972
(707) 425-5666
Mailing address
2801 WATERMAN BLVD STE 290, FAIRFIELD, CA 94534-2972
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
02/05/2022
Last updated
02/16/2023
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