Provider Demographics
NPI:1922115195
Name:PHAM HUU MINH DDS PC
Entity Type:Organization
Organization Name:PHAM HUU MINH DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:HUU
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-538-5010
Mailing Address - Street 1:6400 A SEVEN CORNERS PLACE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044
Mailing Address - Country:US
Mailing Address - Phone:703-538-5010
Mailing Address - Fax:703-533-3898
Practice Address - Street 1:6400 A SEVEN CORNERS PL
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044
Practice Address - Country:US
Practice Address - Phone:703-538-5010
Practice Address - Fax:703-533-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010064801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty