Individual
DR. CHANDRA THANH-CHUONG PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
3270 LANDESS AVE, SAN JOSE, CA 95132-1230
(408) 565-5296
Mailing address
315 FAIRHAVEN BLVD, WOODBURY, NY 11797-1629
(408) 565-5296
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
054700
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
63201
CA
Other
Enumeration date
11/17/2008
Last updated
11/12/2014
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