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NPI Code Detail

MEDICARE: DR. YAOHSIEN PENG DDS

MEDICARE:  DR. YAOHSIEN  PENG  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0700XProsthodontics048520-1NY
21223P0700XProsthodontics009652CT

General Provider Information

NPI Number : 1003809773
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YAOHSIEN PENG DDS
Provider Business Mailing Address
First Line : 14 GALLIVAN LN
Second Line :
City : UNCASVILLE
State : CT
Zip : 06382-1208
Country : US
Telephone Number : 860-367-0688
Fax Number : 860-367-0668
Provider Business Practice Location Address
First Line : 14 GALLIVAN LN
Second Line :
City : UNCASVILLE
State : CT
Zip : 06382-1208
Country : US
Telephone Number : 860-389-3148
Fax Number : 860-367-0668
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 08/21/2013

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Directions to “ DR. YAOHSIEN PENG DDS” Practice Location

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