Provider Demographics
NPI:1689779142
Name:CAO, LETHU THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LETHU
Middle Name:THI
Last Name:CAO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:THI
Other - Last Name:CAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:507 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448
Mailing Address - Country:US
Mailing Address - Phone:504-554-0596
Mailing Address - Fax:
Practice Address - Street 1:800 C M FAGAN DR
Practice Address - Street 2:SUITE A
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401
Practice Address - Country:US
Practice Address - Phone:985-345-5888
Practice Address - Fax:985-345-5088
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice