Provider Demographics
NPI:1063660538
Name:BUI, PETER Q (DDS, MD)
Entity Type:Individual
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First Name:PETER
Middle Name:Q
Last Name:BUI
Suffix:
Gender:M
Credentials:DDS, MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:990 W FREMONT AVE
Mailing Address - Street 2:SUITE X
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3021
Mailing Address - Country:US
Mailing Address - Phone:408-677-6408
Mailing Address - Fax:408-462-9136
Practice Address - Street 1:990 W FREMONT AVE
Practice Address - Street 2:SUITE X
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3021
Practice Address - Country:US
Practice Address - Phone:408-677-6408
Practice Address - Fax:408-462-9136
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2021-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAOMS921223S0112X
CAA108673204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery