Healthcare Provider Details

I. General information

NPI: 1841245826
Provider Name (Legal Business Name): MINHTON CAO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 WULFF RD E
SEMMES AL
36575-5256
US

IV. Provider business mailing address

PO BOX 2867
MOBILE AL
36652-2867
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-0582
  • Fax: 251-445-0584
Mailing address:
  • Phone: 251-690-8894
  • Fax: 251-544-2188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberLNO5234
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: