Healthcare Provider Details

I. General information

NPI: 1902972938
Provider Name (Legal Business Name): TU CATHERINE DAO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12511 BROOKHURST ST
GARDEN GROVE CA
92840-4806
US

IV. Provider business mailing address

12511 BROOKHURST ST
GARDEN GROVE CA
92840-4806
US

V. Phone/Fax

Practice location:
  • Phone: 714-530-9801
  • Fax: 714-620-8217
Mailing address:
  • Phone: 714-530-9801
  • Fax: 714-620-8217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number46176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: