Pham, Jacqueline Tuyen

Pham, Jacqueline Tuyen is an individual health care provider with primary practice located at 4649 Buford Hwy , Chamblee GA 30341. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Pham, Jacqueline Tuyen can be contacted via phone (770) 452-1400.

Contact Information

Primary practice address
4649 Buford Hwy Chamblee GA 30341
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN0112567 Georgia

Profile Details

NPI number 1609096049
LBN Legal business name Pham, Jacqueline Tuyen
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609096049 NPPES
Georgia MEDICAID 00787333
Georgia Other 677H
Georgia Other 101189

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