Provider Demographics
NPI:1679982094
Name:MA, MICHAEL HY BUU (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HY BUU
Last Name:MA
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 1:3171 ROSEMEAD PL
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2866
Mailing Address - Country:US
Mailing Address - Phone:626-759-4956
Mailing Address - Fax:
Practice Address - Street 1:2815 W SUNSET BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-2168
Practice Address - Country:US
Practice Address - Phone:801-209-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS101469122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist