Individual
DR. MATTHEW TRAN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1111 S POLLOCK ST, SELMA, NC 27576-2933
(919) 965-2552
Mailing address
1631 WETZEL AVE BLDG 815, FORT CARSON, CO 80913-4095
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11018
TN
122300000X
Dentist
Primary
12549
NC
171000000X
Military Health Care Provider
—
—
Other
Enumeration date
08/21/2018
Last updated
06/12/2024
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