Individual
ALIVIA CAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2102 W RANDOLPH ST, VANDALIA, IL 62471-1973
(618) 283-4900
Mailing address
1210 N SOMERSET LN, WOODRIDGE, IL 60517-7572
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033624
IL
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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