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General NPI Number Information
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NPI Number | 1043392996
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Entity Type | Individual
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Provider Name | CHRISTOPHER YAKUBU EMUEDUE DMD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 06/22/2009
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Provider Practice Location Address
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Address Line | 3616 S LANCASTER RD
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City | DALLAS
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State | TX
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Zip | 75216-5629
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Country | US
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Telephone | 214-374-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 8005 EDENMORE LN
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City | ROWLETT
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State | TX
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Zip | 75089-4805
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Country | US
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Telephone | 618-420-4313
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0023004
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License Number State | TX
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