Provider Demographics
NPI:1356300636
Name:BUI, TOAN NGUYEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOAN
Middle Name:NGUYEN
Last Name:BUI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-2303
Mailing Address - Country:US
Mailing Address - Phone:717-838-1338
Mailing Address - Fax:717-838-7003
Practice Address - Street 1:117 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-2303
Practice Address - Country:US
Practice Address - Phone:717-838-1338
Practice Address - Fax:717-838-7003
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-207322-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice