Provider Demographics
NPI:1154702306
Name:BUI, NHU MINH (DMD)
Entity type:Individual
Prefix:
First Name:NHU MINH
Middle Name:
Last Name:BUI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MINH NHU
Other - Middle Name:
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:70 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3312
Mailing Address - Country:US
Mailing Address - Phone:617-257-5763
Mailing Address - Fax:
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3312
Practice Address - Country:US
Practice Address - Phone:617-257-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1856926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist