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General NPI Number Information
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NPI Number | 1477805117
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Entity Type | Organization
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Legal Business Name | HAN PHUONG BUI, D.D.S, INC.
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 9191 BOLSA AVENUE SUITE 103
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-891-6769
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Fax | 714-373-5019
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Provider Business Mailing Address
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Address Line | 9191 BOLSA AVENUE SUITE 103
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-891-6769
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Fax | 714-373-5019
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Authorized Official
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Title or Position | GENERAL DENTIST/OWNER
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Name | HAN PHUONG BUI
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Credential | D.D.S
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Telephone | 714-891-6769
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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 | 45656
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License Number State | CA
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