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Individual

DR. ANH HUU PHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
19441 GOLF VISTA PLAZA, SUITE 130, LANSDOWNE, VA 20176
(703) 723-7858
(703) 723-7882
Mailing address
19441 GOLF VISTA PLAZA, SUITE 130, LANSDOWNE, VA 20176
(703) 723-7858
(703) 723-7882

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
VA0404006304
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401006304
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0438000026
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008000841
VA
Enumeration date
06/15/2006
Last updated
08/21/2013
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