Healthcare Provider Details

I. General information

NPI: 1588789192
Provider Name (Legal Business Name): RICHARD C YEE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5908 STANLEY AVE
CARMICHAEL CA
95608-3804
US

IV. Provider business mailing address

5908 STANLEY AVE
CARMICHAEL CA
95608
US

V. Phone/Fax

Practice location:
  • Phone: 916-485-5745
  • Fax: 916-485-5778
Mailing address:
  • Phone: 916-485-5745
  • Fax: 916-485-5778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number51530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: