Provider Demographics
NPI:1629296868
Name:PHAM & CAO DENTAL CORP
Entity Type:Organization
Organization Name:PHAM & CAO DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:HUNG
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-726-7500
Mailing Address - Street 1:249 E BEVERLY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3799
Mailing Address - Country:US
Mailing Address - Phone:323-726-7500
Mailing Address - Fax:323-726-7503
Practice Address - Street 1:249 E BEVERLY BLVD STE A
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3799
Practice Address - Country:US
Practice Address - Phone:323-726-7500
Practice Address - Fax:323-726-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty