Healthcare Provider Details

I. General information

NPI: 1487637799
Provider Name (Legal Business Name): JAMES G. YANKOWSKAS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PONDVIEW PL
TYNGSBORO MA
01879-1068
US

IV. Provider business mailing address

15 PONDVIEW PL
TYNGSBORO MA
01879-1068
US

V. Phone/Fax

Practice location:
  • Phone: 978-649-7773
  • Fax: 978-649-5357
Mailing address:
  • Phone: 978-649-7773
  • Fax: 978-649-5357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number15880
License Number StateMA

VIII. Authorized Official

Name: DR. JAMES G. YANKOWSKAS
Title or Position: PRESIDENT
Credential: DDS
Phone: 978-649-7773