Organization
COSTA MESA ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE DUONG PHAM DDS, MD (OWNER, PARTNER)
(310) 849-4690
Entity
Organization
Contact information
Practice address
2900 BRISTOL ST STE D101, COSTA MESA, CA 92626-5939
(562) 598-4683
Mailing address
4582 KATELLA AVE, LOS ALAMITOS, CA 90720-2655
(310) 849-4690
(562) 598-4693
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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