Provider Demographics
NPI:1497211726
Name:KAI GAO DMD LLC
Entity type:Organization
Organization Name:KAI GAO DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-455-4686
Mailing Address - Street 1:17 COTTER RD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1035
Mailing Address - Country:US
Mailing Address - Phone:617-858-9893
Mailing Address - Fax:
Practice Address - Street 1:535 WORCESTER RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5364
Practice Address - Country:US
Practice Address - Phone:508-455-4686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty