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Organization

DIEP PHAM DDS, INC

Active
Parent organization
DIEP PHAM DDS, INC
Other names
Gulf Coast Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
DIEP PHAM DDS, INC
Authorized official
DIEP PHAM (PRESIDENT)
(281) 208-2016
Entity
Organization

Contact information

Practice address
309 GARLAND DR, LAKE JACKSON, TX 77566-6238
(979) 480-9300
Mailing address
PO BOX 2086, ALIEF, TX 77411-2086

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17862
TX

Other

Enumeration date
04/19/2012
Last updated
04/19/2012
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