Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 3723 | NV |
NPI | 1043396906 |
---|---|
Provider Name | Dr. Quang Dang Minh Bui |
First Address | Las Vegas, NV 89145 |
Second Address | Las Vegas, NV 89145-0302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 11/07/2008 |