Provider Demographics
NPI:1770785974
Name:BUI, LAN QUOC (DDS)
Entity type:Individual
Prefix:DR
First Name:LAN
Middle Name:QUOC
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 1:932 HUNGERFORD DR
Mailing Address - Street 2:SUITE 36A
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1713
Mailing Address - Country:US
Mailing Address - Phone:301-279-2886
Mailing Address - Fax:301-279-2896
Practice Address - Street 1:932 HUNGERFORD DR
Practice Address - Street 2:SUITE 36A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1713
Practice Address - Country:US
Practice Address - Phone:301-279-2886
Practice Address - Fax:301-279-2896
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD95791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice