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General NPI Number Information
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NPI Number | 1093088957
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Entity Type | Individual
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Provider Name | HALEY BUI
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Gender | Female
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 05/17/2017
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Provider Practice Location Address
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Address Line | 3330 KINGMAN ST STE 1
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City | METAIRIE
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State | LA
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Zip | 70006-4235
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Country | US
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Telephone | 504-305-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 W ESPLANADE AVE APT 12D
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City | KENNER
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State | LA
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Zip | 70065-5312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6267
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License Number State | LA
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