Organization
DERRICK PHAM DDS PROFESSIONAL CORPORATION DBA LV DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK PHAM DDS (PRESIDENT)
(714) 417-0246
Entity
Organization
Contact information
Practice address
4705 S DURANGO DR STE 115, LAS VEGAS, NV 89147-8162
(714) 417-0246
Mailing address
4705 S DURANGO DR STE 115, LAS VEGAS, NV 89147-8162
(714) 417-0246
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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