Healthcare Provider Details

I. General information

NPI: 1750593745
Provider Name (Legal Business Name): WILLIAM P. YEOMANS, DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 SANDERSON AVE
SCRANTON PA
18509-1853
US

IV. Provider business mailing address

1736 SANDERSON AVE
SCRANTON PA
18509-1853
US

V. Phone/Fax

Practice location:
  • Phone: 570-343-5761
  • Fax: 570-961-3355
Mailing address:
  • Phone: 570-343-5761
  • Fax: 570-961-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS018595L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. WILLIAM PETER YEOMANS
Title or Position: PRESIDENT
Credential: DDS
Phone: 570-343-5761