Provider Demographics
NPI:1750977922
Name:DAO, QUANG (BS)
Entity type:Individual
Prefix:MR
First Name:QUANG
Middle Name:
Last Name:DAO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MENDON RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-5327
Mailing Address - Country:US
Mailing Address - Phone:401-722-3401
Mailing Address - Fax:401-722-4168
Practice Address - Street 1:70 MENDON RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-5327
Practice Address - Country:US
Practice Address - Phone:401-722-3401
Practice Address - Fax:401-722-4168
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI03886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist