Individual
DR. BENJAMIN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2020 8TH AVE STE 121, WEST LINN, OR 97068-4657
(503) 305-6505
Mailing address
2020 8TH AVE STE 121, WEST LINN, OR 97068-4657
(503) 305-6505
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
056971-1
NY
1223P0221X
Pediatric Dentistry
64392
CA
1223P0221X
Pediatric Dentistry
Primary
D10575
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03818279
—
NY
Enumeration date
09/14/2013
Last updated
11/30/2020
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