Individual
PHUONG T. PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
17 DANIELS ST, WORCESTER, MA 01604-1611
(508) 798-8525
(508) 756-8814
Mailing address
17 DANIELS ST, WORCESTER, MA 01604-1611
(508) 798-8525
(508) 756-8814
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17549
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X06354
BC & BS DENTAL
MA
Enumeration date
07/18/2006
Last updated
07/08/2007
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