| Ngo & Pham Dental Group | |
|
502 W Grand Blvd Corona CA 92882-2118 | |
| (951) 549-0878 | |
| (951) 496-4011 |
| Full Name | Ngo & Pham Dental Group |
|---|---|
| Speciality | Clinic/center |
| Location | 502 W Grand Blvd, Corona, California |
| Authorized Official Name and Position | Tung Son Ngo (OWNER) |
| Authorized Official Contact | 9515490878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ngo & Pham Dental Group 502 W Grand Blvd Corona CA 92882-2118 Ph: (951) 549-0878 | Ngo & Pham Dental Group 502 W Grand Blvd Corona CA 92882-2118 Ph: (951) 549-0878 |
| NPI Number | 1396323671 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 03/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396323671 | NPI | - | NPPES |
| 1831267053 | Medicaid | CA | |
| 1689741159 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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