Organization
CAVITYBUSTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUANG M.D. BUI D.M.D. (OWNER)
(702) 362-5437
Entity
Organization
Contact information
Practice address
6910 S RAINBOW BLVD, #104, LAS VEGAS, NV 89118-3273
(702) 362-5437
(702) 631-5437
Mailing address
6910 S RAINBOW BLVD, #104, LAS VEGAS, NV 89118-3273
(702) 362-5437
(702) 631-5437
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
S5-62
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043396906
—
NV
05
—
880491583
—
NV
Enumeration date
11/20/2008
Last updated
04/07/2009
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