| Mary R. Pham, D.d.s., Inc. | |
|
2750 Harbor Blvd # B-06 Costa Mesa CA 92626-5121 | |
| (334) 657-7668 | |
| Not Available |
| Full Name | Mary R. Pham, D.d.s., Inc. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2750 Harbor Blvd # B-06, Costa Mesa, California |
| Authorized Official Name and Position | Paul Pham (MANAGER) |
| Authorized Official Contact | 3346577668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary R. Pham, D.d.s., Inc. 2750 Harbor Blvd # B-06 Costa Mesa CA 92626-5121 Ph: (334) 657-7668 | Mary R. Pham, D.d.s., Inc. 2750 Harbor Blvd # B-06 Costa Mesa CA 92626-5121 Ph: (334) 657-7668 |
| NPI Number | 1164986220 |
|---|---|
| Provider Enumeration Date | 01/23/2019 |
| Last Update Date | 01/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164986220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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