Provider Demographics
NPI:1366637878
Name:PHAM, TUYEN T (DMD, MS)
Entity Type:Individual
Prefix:
First Name:TUYEN
Middle Name:T
Last Name:PHAM
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N FRANKLIN DRIVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-365-7775
Mailing Address - Fax:724-365-7885
Practice Address - Street 1:125 N FRANKLIN DRIVE
Practice Address - Street 2:SUITE 4
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-365-7775
Practice Address - Fax:724-365-7885
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0371221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics