Provider Demographics
NPI:1689890915
Name:BUI, MICHELLE TRUC (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:TRUC
Last Name:BUI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1383
Mailing Address - Country:US
Mailing Address - Phone:714-775-0202
Mailing Address - Fax:714-775-8735
Practice Address - Street 1:642 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-1383
Practice Address - Country:US
Practice Address - Phone:714-775-0202
Practice Address - Fax:714-775-8735
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist