Organization
DENTAL 1, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AI-PHUONG PHAM DMD (PRESIDENT)
(617) 698-0600
Entity
Organization
Contact information
Practice address
480 ADAMS ST, SUITE 104, MILTON, MA 02186-4914
(617) 698-0600
Mailing address
480 ADAMS ST, SUITE 104, MILTON, MA 02186-4914
(617) 698-0600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN21661
MA
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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