Provider Demographics
NPI:1851649248
Name:DUNG Q PHAM DDS / CATHY H PHAM DDS
Entity Type:Organization
Organization Name:DUNG Q PHAM DDS / CATHY H PHAM DDS
Other - Org Name:PHAMS DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DD S
Authorized Official - Phone:510-536-8000
Mailing Address - Street 1:1400 E 14TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-4493
Mailing Address - Country:US
Mailing Address - Phone:510-536-8000
Mailing Address - Fax:
Practice Address - Street 1:1400 E 14TH ST STE E
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-4493
Practice Address - Country:US
Practice Address - Phone:510-536-8000
Practice Address - Fax:510-532-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42494261QD0000X
CA42212261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental