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General NPI Number Information
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NPI Number | 1720380934
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Entity Type | Individual
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Provider Name | THO BUI DDS
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Gender | Male
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 591 FALLEN LEAF CIR
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City | SAN RAMON
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State | CA
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Zip | 94583-5305
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Country | US
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Telephone | 682-552-3102
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Fax |
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Provider Business Mailing Address
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Address Line | 591 FALLEN LEAF CIR
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City | SAN RAMON
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State | CA
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Zip | 94583-5305
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Country | US
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Telephone | 682-552-3102
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25733
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 62110
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License Number State | CA
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