Mary R Pham DDS Dental Corporation
NPI #1194491738 in Lake Forest, California
Provider Information
- NPI Number
- 1194491738
- Entity Type
- Organization
- Organization Name
- Mary R Pham DDS Dental Corporation
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Aug 23, 2021
- Last Updated
- Aug 25, 2021
Practice Location
- Address
- 12751-21771 LAKE FOREST LANE DR.
- Address 2
- SUITE 21
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630
- Phone
- (714) 528-8252
Authorized Official
- Name
- DR. MARY REGINA PHAM, D.D.S
- Title
- CEO/PEDIATRIC DENTIST
- Phone
- (714) 528-8252
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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