Individual
HONGYEN PHAM NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5306 VAN DYKE RD, LUTZ, FL 33558-4829
(813) 963-1900
(813) 963-1991
Mailing address
7250 BARQUE DR, TAMPA, FL 33607-5867
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66692
BLUE CROSS BLUE SHIELD PROVIDER
FL
Enumeration date
09/08/2006
Last updated
09/03/2008
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