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General NPI Number Information
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NPI Number | 1023221264
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Entity Type | Individual
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Provider Name | DAVID SAMUEL YUDKOWSKY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 8800 BRONX AVE
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City | SKOKIE
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State | IL
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Zip | 60077-1804
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Country | US
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Telephone | 847-676-6512
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Fax | 847-676-6502
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Provider Business Mailing Address
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Address Line | 9341 AVERS AVE
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City | EVANSTON
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State | IL
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Zip | 60203-1312
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Country | US
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Telephone | 847-676-6512
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Fax | 847-676-6502
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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