| NPI | 1376170266 |
|---|---|
| Former Name | JENNIFER PHAM NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL 26322) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16850) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-04-09 |