Provider Demographics
NPI:1023180585
Name:PHAM, DAO M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAO
Middle Name:M
Last Name:PHAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 ALMA DR STE 123
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3483
Mailing Address - Country:US
Mailing Address - Phone:972-517-8090
Mailing Address - Fax:
Practice Address - Street 1:7801 ALMA DR STE 123
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3483
Practice Address - Country:US
Practice Address - Phone:972-517-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice