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General NPI Number Information
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NPI Number | 1205358173
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Entity Type | Individual
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Provider Name | DENNIS NGUYEN CAO DMD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 460 KELLER PKWY
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City | KELLER
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State | TX
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Zip | 76248-2370
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Country | US
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Telephone | 817-242-6374
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Fax |
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Provider Business Mailing Address
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Address Line | 120 HEMLOCK DR
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City | DIBERVILLE
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State | MS
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Zip | 39540-3604
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Country | US
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Telephone | 228-392-6438
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3920-17
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6435-C1
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37099
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License Number State | TX
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