Provider Demographics
NPI:1609289172
Name:CAO, TOMMY (DMD)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:
Last Name:CAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 FARNSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-4140
Mailing Address - Country:US
Mailing Address - Phone:484-343-6075
Mailing Address - Fax:
Practice Address - Street 1:1325 W AIRY ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-4357
Practice Address - Country:US
Practice Address - Phone:610-275-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist