| Grant And Pham Dental Corporation | |
|
9710 Winter Gardens Blvd Lakeside CA 92040-3866 | |
| (619) 443-8447 | |
| Not Available |
| Full Name | Grant And Pham Dental Corporation |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 9710 Winter Gardens Blvd, Lakeside, California |
| Authorized Official Name and Position | Richard Grant (OWNER) |
| Authorized Official Contact | 8582053872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant And Pham Dental Corporation 9710 Winter Gardens Blvd Lakeside CA 92040-3866 Ph: () - | Grant And Pham Dental Corporation 9710 Winter Gardens Blvd Lakeside CA 92040-3866 Ph: (619) 443-8447 |
| NPI Number | 1457588055 |
|---|---|
| Provider Enumeration Date | 06/22/2009 |
| Last Update Date | 07/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457588055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 52916 (California) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 51412 (California) | Primary |
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