Provider Demographics
NPI:1841245826
Name:CAO, MINHTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MINHTON
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:PO BOX 2867
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2867
Mailing Address - Country:US
Mailing Address - Phone:251-690-8894
Mailing Address - Fax:251-544-2188
Practice Address - Street 1:3810 WULFF RD E
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5256
Practice Address - Country:US
Practice Address - Phone:251-445-0582
Practice Address - Fax:251-445-0584
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLNO5234122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1063439065OtherGROUP PAYEE NPI NUMBER
AL631503053Medicaid
AL011846OtherMEDICARE GROUP NUMBER