| NPI | 1275752636 |
|---|---|
| Former Name | QUANG NGUYEN PHAM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 13272) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 16792) |
| 1223G0001X Dentist, General Practice (Licence: CA 39869) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |