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General NPI Number Information
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NPI Number | 1023221777
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Entity Type | Organization
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Legal Business Name | EAST ORLANDO DENTAL, PA
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 11780 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32817-4626
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Country | US
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Telephone | 407-282-2101
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Fax |
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Provider Business Mailing Address
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Address Line | 11780 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32817-4626
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Country | US
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Telephone | 407-282-2101
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. GEORGE ALAN YARKO
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Credential | D.D.S.
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Telephone | 407-282-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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