Provider Demographics
NPI:1548423197
Name:QUAN MINH PHAM DDS
Entity Type:Organization
Organization Name:QUAN MINH PHAM DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-327-6685
Mailing Address - Street 1:3600 CAMBRIDGE ST # 1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-4003
Mailing Address - Country:US
Mailing Address - Phone:702-732-3600
Mailing Address - Fax:702-369-9963
Practice Address - Street 1:3600 CAMBRIDGE ST # 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-4003
Practice Address - Country:US
Practice Address - Phone:702-732-3600
Practice Address - Fax:702-369-9963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4277122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty