Individual
JULIA THACH THAO PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
438 W PARK DR, FULTONDALE, AL 35068-6075
(251) 391-5328
Mailing address
438 W PARK DR, FULTONDALE, AL 35068-6075
(251) 391-5328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-0007093-C1
AL
2255A2300X
Athletic Trainer
—
AL
Other
Enumeration date
05/27/2022
Last updated
10/21/2024
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