Individual
TUAN DUC PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7669 W EMERALD ST, BOISE, ID 83704-9018
(949) 831-0051
(208) 488-4477
Mailing address
7669 W EMERALD ST, BOISE, ID 83704-9018
(208) 994-7426
(208) 488-4477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4465
ID
1223G0001X
General Practice Dentistry
48663
CA
Other
Enumeration date
06/06/2007
Last updated
02/28/2024
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