Individual
DR. JACOB H. PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6212 PETERS CREEK RD, ROANOKE, VA 24019-4026
(540) 563-0519
(540) 563-1184
Mailing address
6212 PETERS CREEK RD, ROANOKE, VA 24019-4026
(540) 563-0519
(540) 563-1184
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413420
VA
1223G0001X
General Practice Dentistry
0401413420
VA
Other
Enumeration date
11/02/2005
Last updated
02/22/2016
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