Organization
CLERMONT MODERN DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINH PHAM DDS (OWNER DENTIST)
(714) 845-8890
Entity
Organization
Contact information
Practice address
17300 STATE ROAD 50, CLERMONT, FL 34711-8140
(352) 403-1298
(352) 415-8365
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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