Provider Demographics
NPI:1912934167
Name:PHAM, THUAN N (DDS)
Entity Type:Individual
Prefix:DR
First Name:THUAN
Middle Name:N
Last Name:PHAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3972 SPINNAKER RUN PT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-3110
Mailing Address - Country:US
Mailing Address - Phone:972-999-7342
Mailing Address - Fax:
Practice Address - Street 1:4550 SWISHER ROAD
Practice Address - Street 2:
Practice Address - City:HICKORY CREEK
Practice Address - State:TX
Practice Address - Zip Code:75065
Practice Address - Country:US
Practice Address - Phone:972-999-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist