Provider Demographics
NPI:1548077126
Name:TUAN CAO DDS PC
Entity type:Organization
Organization Name:TUAN CAO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-458-1217
Mailing Address - Street 1:4529 SAINT MARY ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2434 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4113
Practice Address - Country:US
Practice Address - Phone:708-689-6789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental