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General NPI Number Information
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NPI Number | 1457552010
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Entity Type | Individual
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Provider Name | THAO H BUI D.M.D
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4601 N. CUMBERLAND AVENUE
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City | NORRIDGE
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State | IL
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Zip | 60706
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Country | US
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Telephone | 708-452-1880
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Fax | 708-452-5004
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Provider Business Mailing Address
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Address Line | 850 N DEWITT PL UNIT 22B
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City | CHICAGO
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State | IL
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Zip | 60611-2361
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Country | US
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Telephone | 312-787-0863
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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