Individual
THAO CAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
387 NE 223RD AVE, GRESHAM, OR 97030-8554
(503) 491-5450
Mailing address
387 NE 223RD AVE, GRESHAM, OR 97030-8554
(503) 491-5450
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11687
OR
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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