Organization
GINA C PHAM DDS PC
Active
Other names
BRITESTARS PEDIATRIC DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA C PHAM DDS (PEDIATRIC DENTIST)
(703) 490-5050
Entity
Organization
Contact information
Practice address
12602 LAKE RIDGE DR, WOODBRIDGE, VA 22192-2335
(703) 490-5050
Mailing address
PO BOX 10083, MC LEAN, VA 22102-8083
(703) 626-8196
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401411775
VA
Other
Enumeration date
08/27/2009
Last updated
02/08/2022
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