Organization
JOHN PHAM DDS PC
Active
Other names
Hollywood Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PHAM DDS (PRESIDENT)
(503) 331-1322
Entity
Organization
Contact information
Practice address
4301 NE TILLAMOOK, PORTLAND, OR 97213
(503) 331-1322
Mailing address
1515 NW LOUISIANA AVE, CHEHALIS, WA 98532
(360) 740-6212
(360) 740-6222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6843
OR
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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