Organization
SHININGSTARS PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA CUC PHAM DDS (PRESIDENT)
(703) 586-7119
Entity
Organization
Contact information
Practice address
435 INGRAHAM ST NE, WASHINGTON, DC 20011
(202) 600-4833
(202) 635-5555
Mailing address
PO BOX 10083, MCLEAN, VA 22102
(703) 586-7119
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
06/14/2022
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