Provider Demographics
NPI:1043986359
Name:DAO, ANNA A (DMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:A
Last Name:DAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39863 HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-7802
Mailing Address - Country:US
Mailing Address - Phone:863-216-3369
Mailing Address - Fax:863-216-3368
Practice Address - Street 1:39863 HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-7802
Practice Address - Country:US
Practice Address - Phone:863-216-3369
Practice Address - Fax:863-216-3368
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4547122300000X
FL26313122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist