MEDICARE: STUART S YOON, DDS, PA

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
1	122300000X	Dentist	8065	NC

General Provider Information

NPI Number	:	1114199098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STUART S YOON, DDS, PA

Provider Business Mailing Address
First Line	:	1396 SAND HILL ROAD
Second Line	:	SUITE 4
City	:	CANDLER
State	:	NC
Zip	:	28715-8937
Country	:	US
Telephone Number	:	828-670-1966
Fax Number	:	828-670-1964

Provider Business Practice Location Address
First Line	:	1396 SAND HILL ROAD
Second Line	:	SUITE 4
City	:	CANDLER
State	:	NC
Zip	:	28715-8937
Country	:	US
Telephone Number	:	828-670-1966
Fax Number	:	828-670-1964

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STUART S YOON
Credential	:	DDS
Telephone Number	:	828-670-1966

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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