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General NPI Number Information
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NPI Number | 1043422439
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Entity Type | Organization
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Legal Business Name | RANDALL D. J. YEE, DDS, MSD, INC.
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Dates
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Enumeration Date | 05/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1063 LOWER MAIN ST STE C224
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City | WAILUKU
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State | HI
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Zip | 96793-2096
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Country | US
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Telephone | 808-242-6857
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Fax |
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Provider Business Mailing Address
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Address Line | 1063 LOWER MAIN ST STE C224
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City | WAILUKU
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State | HI
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Zip | 96793-2096
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Country | US
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Telephone | 808-242-6857
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDALL D.J. YEE
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Credential | DDS
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Telephone | 808-242-6857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DT-1111
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License Number State | HI
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