Healthcare Provider Details

I. General information

NPI: 1093884736
Provider Name (Legal Business Name): EDWIN E YEE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 N DAVIS HWY SUITE 6
PENSACOLA FL
32504-6994
US

IV. Provider business mailing address

6160 N DAVIS HWY SUITE 6
PENSACOLA FL
32504-6994
US

V. Phone/Fax

Practice location:
  • Phone: 850-479-3355
  • Fax: 850-479-3377
Mailing address:
  • Phone: 850-479-3355
  • Fax: 850-479-3377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: