Healthcare Provider Details

I. General information

NPI: 1023863065
Provider Name (Legal Business Name): WILLIAM HUY CAO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 KILLIAN HILL RD SW STE 100
LILBURN GA
30047-8976
US

IV. Provider business mailing address

912 KILLIAN HILL RD SW STE 100
LILBURN GA
30047-8976
US

V. Phone/Fax

Practice location:
  • Phone: 770-923-3966
  • Fax:
Mailing address:
  • Phone: 770-923-3966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN123417
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: