Individual
DR. ANNIE T PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3780 SW HALL BLVD, BEAVERTON, OR 97005-2050
(503) 646-1588
Mailing address
3315 SW VESTA CT, PORTLAND, OR 97219-9229
(503) 646-1588
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8511
OR
Other
Enumeration date
03/29/2007
Last updated
08/01/2011
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