Healthcare Provider Details

I. General information

NPI: 1780700047
Provider Name (Legal Business Name): BRIAN KENT YEE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 EL CAMINO REAL
REDWOOD CITY CA
94063-1632
US

IV. Provider business mailing address

1059 EL CAMINO REAL
REDWOOD CITY CA
94063-1632
US

V. Phone/Fax

Practice location:
  • Phone: 650-299-0608
  • Fax:
Mailing address:
  • Phone: 650-299-0608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number47680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: