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General NPI Number Information
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NPI Number | 1548077126
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Entity Type | Organization
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Legal Business Name | TUAN CAO DDS PC
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2434 W PETERSON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-4113
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Country | US
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Telephone | 708-689-6789
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Fax |
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Provider Business Mailing Address
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Address Line | 4529 SAINT MARY ST
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City | METAIRIE
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State | LA
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Zip | 70006-2029
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TUAN CAO
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Credential | DDS
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Telephone | 504-458-1217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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