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General NPI Number Information
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NPI Number | 1417350992
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Entity Type | Organization
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Legal Business Name | MICHAEL H LUU DMD INC
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 820 WILLOW ST SUITE 150
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City | SAN JOSE
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State | CA
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Zip | 95125-2396
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Country | US
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Telephone | 408-298-2988
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Fax | 408-298-2989
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Provider Business Mailing Address
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Address Line | 820 WILLOW ST SUITE 150
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City | SAN JOSE
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State | CA
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Zip | 95125-2396
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Country | US
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Telephone | 408-298-2988
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Fax | 408-298-2989
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Authorized Official
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Title or Position | DENTIST/ OWNER
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Name | DR. MICHAEL H LUU
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Credential | DMD
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Telephone | 408-298-2988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | B48827
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License Number State | CA
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