Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 5598 | LA |
NPI | 1093939373 |
---|---|
Provider Name | Dr. Linda Thi Cao |
First Address | Harahan, LA 70123-7803 |
Second Address | Harvey, LA 70058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 30/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1855987 | (05) | LA |