MEDICARE: DR. MUU N DO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	40149	CA

General Provider Information

NPI Number	:	1376587204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUU N DO DDS

Provider Business Mailing Address
First Line	:	9010 BOLSA AVE
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-5531
Country	:	US
Telephone Number	:	714-892-5710
Fax Number	:	714-890-9795

Provider Business Practice Location Address
First Line	:	9010 BOLSA AVE
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-5531
Country	:	US
Telephone Number	:	714-892-5710
Fax Number	:	714-890-9795

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	09/02/2015

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