Individual
MICHELLE MARTINEZ PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
545 MARKS ST, HENDERSON, NV 89014-6500
(702) 425-3697
(702) 450-6539
Mailing address
545 MARKS ST, HENDERSON, NV 89014-6500
(702) 425-3697
(702) 450-6539
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
45733
CA
1223G0001X
General Practice Dentistry
Primary
5004
NV
Other
Enumeration date
10/25/2006
Last updated
10/01/2012
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