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1104273085
THIEN QUANG PHAM
BLAINE, MN
NPI
1104273085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MN D13682)
Enumeration Date
2016-05-19
Last Update Date
2016-05-19
Business Address
Dr. THIEN QUANG PHAM D.D.S.
12904 CENTRAL AVE NE
BLAINE, MN 55434-4147
Phone number: 651-621-4515
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Mailing Address
Dr. THIEN QUANG PHAM D.D.S.
12904 CENTRAL AVE NE
BLAINE, MN 55434-4147
Phone number: 651-621-4515
Copy
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