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Organization

SHAWN PHAM, DDS, PLLC.

Active
Other names
Luna Dental
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN PHAM DDS (SOLE MEMBER)
(253) 222-9269
Entity
Organization

Contact information

Practice address
10209 BRIDGEPORT WAY SW STE B10, LAKEWOOD, WA 98499-2327
(253) 222-9269
Mailing address
650 DUVALL AVE NE APT R1323, RENTON, WA 98059-4775
(253) 222-9269

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/13/2023
Last updated
12/13/2023
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