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Provider Information for 1689890915



DR. MICHELLE TRUC BUI DDS

Gender: FEMALE

Individual NPI: 1689890915

Calendar Last Updated: 2008-01-30

Details

Name Value
NPI 1689890915
Enumeration Date 2007-04-17
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 642 S HARBOR BLVD
SANTA ANA, CA 92704-1383
United States

Phone: 714-775-0202 | Fax: 714-775-8735
View Map External Link
Primary Practice Address 642 S HARBOR BLVD
SANTA ANA, CA 92704-1383
United States

Phone: 714-775-0202 | Fax: 714-775-8735
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 53054