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General NPI Number Information
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NPI Number | 1396264180
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Entity Type | Organization
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Legal Business Name | SON BUI DMD PLLC
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 09/13/2017
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Provider Practice Location Address
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Address Line | 14820 PACIFIC AVE S
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City | TACOMA
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State | WA
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Zip | 98444-4655
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Country | US
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Telephone | 832-628-8604
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Fax | 281-855-4511
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Provider Business Mailing Address
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Address Line | 205 E 25TH ST
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City | HOUSTON
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State | TX
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Zip | 77008-2523
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Country | US
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Telephone | 832-628-8604
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SON NGUYEN BUI
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Credential | DMD
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Telephone | 832-628-8604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE00010979
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License Number State | WA
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