Healthcare Provider Details

I. General information

NPI: 1831864313
Provider Name (Legal Business Name): HUILIN CAO DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 LONGWOOD AVE
BOSTON MA
02115-5819
US

IV. Provider business mailing address

188 LONGWOOD AVE
BOSTON MA
02115-5819
US

V. Phone/Fax

Practice location:
  • Phone: 617-432-1434
  • Fax:
Mailing address:
  • Phone: 617-432-1434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1859185
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: