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25464 Sierra Center Blvd Lutz FL 33559-7322 | |
| (813) 296-2028 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 25464 Sierra Center Blvd, Lutz, Florida |
| Authorized Official Name and Position | Minh B Pham (OWNER/DDS) |
| Authorized Official Contact | 8132962028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8500 | 25464 Sierra Center Blvd Lutz FL 33559-7322 Ph: (813) 296-2028 |
| NPI Number | 1982178612 |
|---|---|
| Provider Enumeration Date | 01/16/2019 |
| Last Update Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982178612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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