Individual
EDWARD PEER PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3075 SE CENTURY BLVD STE 109, HILLSBORO, OR 97123-8187
(503) 642-1535
Mailing address
3075 SE CENTURY BLVD STE 109, HILLSBORO, OR 97123-8187
(503) 642-1535
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D11678
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2022
Last updated
10/31/2024
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