Taylor Pham

NPI #1124689138 in East Peoria, Illinois

Provider Information

NPI Number: 1124689138
Entity Type: Individual
Name: Taylor Pham
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Jun 21, 2019
Last Updated: Jun 21, 2019

Practice Location

Address: 368 W WASHINGTON ST
City: East Peoria
State: Illinois
ZIP Code: 61611-2036
Phone: (309) 694-4444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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