Individual
HUNG QUOC PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(385) 202-9721
Mailing address
2263 W AUGUST FARMS CIR, WEST VALLEY, UT 84119-6044
(385) 202-9721
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11263872-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2018
Last updated
06/05/2019
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