Provider Demographics
NPI:1629315452
Name:PHAM, NGUYEN, ANWAR PLLC
Entity Type:Organization
Organization Name:PHAM, NGUYEN, ANWAR PLLC
Other - Org Name:SMILE NOW DENTAL OF ARLINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-773-4909
Mailing Address - Street 1:3704 172ND ST NE STE E
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6336
Mailing Address - Country:US
Mailing Address - Phone:425-773-4909
Mailing Address - Fax:
Practice Address - Street 1:3704 172ND ST NE STE E
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-6336
Practice Address - Country:US
Practice Address - Phone:425-773-4909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010340122300000X
WADE00010639122300000X
WADE00009939122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty