Healthcare Provider Details

I. General information

NPI: 1083538771
Provider Name (Legal Business Name): PRISCILLA OPOKU-YEBOAH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GRAFENWOEHR DENTAL CLINIC BUILDING 475
APO AE
09114
US

IV. Provider business mailing address

BUILDING #475
APO AE
09114
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14294920-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: