Ta, Phong Cam

Ta, Phong Cam is an sole proprietor health care provider with primary practice located at 410 W 53Rd St Apt 126, New York NY 10019-5622. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Dentist Anesthesiologist. Dental Providers / Dentist Anesthesiologist is his primary health care specialty. Ta, Phong Cam can be contacted via phone (215) 527-8768.

Contact Information

Primary practice address
410 W 53Rd St Apt 126 New York NY 10019-5622
Phone: (215) 527-8768
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X P65701 New York
Dental Providers / Dentist Anesthesiologist 1223D0004X 054360 New York

Profile Details

NPI number 1861646747
LBN Legal business name Ta, Phong Cam
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 5th, 2008
Last updated Jun 16th, 2016 - about 9 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 1861646747 NPPES
New York MEDICAID 03203894

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