Healthcare Provider Details

I. General information

NPI: 1639151210
Provider Name (Legal Business Name): GARRY G. YEE, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ROOSEVELT AVE
CARTERET NJ
07008-1513
US

IV. Provider business mailing address

1200 ROOSEVELT AVE
CARTERET NJ
07008-1513
US

V. Phone/Fax

Practice location:
  • Phone: 732-541-1221
  • Fax: 732-541-4199
Mailing address:
  • Phone: 732-541-1221
  • Fax: 732-541-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI01269100
License Number StateNJ

VIII. Authorized Official

Name: DR. GARRY G YEE
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 732-541-1221