| NPI | 1386201366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HIEU TIN NGUYEN PHAM Dentist Owner 408-616-9175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-08-02 |