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Jimmy Duy Pham
General Practice Dentistry in Glen Carbon, Illinois
NPI 1659950087

Jimmy Duy Pham is a General Practice Dentistry based in Westminster, IL and is specialized in General Practice. Jimmy Duy Pham practices in Glen Carbon, IL. The NPI Number for Jimmy Duy Pham is 1659950087 and holds a License No. (Illinois).

The current practice location address for Jimmy Duy Pham is 21 Glen Ed Professional Park, Glen Carbon, IL and can be reached out via phone at 618-656-0608.

Location: 21 Glen Ed Professional Park, Glen Carbon, IL, 92683-5513
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659950087
Provider Name
Jimmy Duy Pham
Credential
Provider Entity Type
Individual
Gender
Male
Address
21 Glen Ed Professional Park, Glen Carbon, IL, 92683-5513
Phone Number
618-656-0608
Fax Number
Provider Enumeration Date
04/04/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
21 Glen Ed Professional Park
City
Glen Carbon
State
Illinois
Zip
62034-3333
Phone Number
618-656-0608
Fax Number
person
Provider Business Mailing Address Details
Address
21 Glen Ed Professional Park
City
Glen Carbon
State
Illinois
Zip
62034-3333
Phone Number
618-656-0608
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2022022932 (Missouri)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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