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9417 Mesa Dr Ste A Houston TX 77028-1253 | |
| (214) 718-7880 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9417 Mesa Dr, Houston, Texas |
| Authorized Official Name and Position | Lynh Pham (OWNER) |
| Authorized Official Contact | 2147187880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 453247 Garland TX 75045-3247 Ph: (214) 718-7880 | 9417 Mesa Dr Ste A Houston TX 77028-1253 Ph: (214) 718-7880 |
| NPI Number | 1073821104 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 09/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073821104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19887 (Texas) | Primary |
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