Healthcare Provider Details

I. General information

NPI: 1962948596
Provider Name (Legal Business Name): YES DENTAL COIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E SEMINARY DR #100
FORT WORTH TX
76115-2607
US

IV. Provider business mailing address

14215 COIT RD #112
DALLAS TX
75254-2800
US

V. Phone/Fax

Practice location:
  • Phone: 972-701-8282
  • Fax: 214-367-5896
Mailing address:
  • Phone: 972-701-8282
  • Fax: 214-367-5896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number28721
License Number StateTX

VIII. Authorized Official

Name: DR. KATI YOON
Title or Position: DENTIST/ OWNER
Credential: DMD
Phone: 214-466-1400