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General NPI Number Information
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NPI Number | 1083751127
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Entity Type | Organization
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Legal Business Name | ROBERT L. YOUNG, JR. , DDS
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11010 S TRYON ST STE 101
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City | CHARLOTTE
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State | NC
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Zip | 28273
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Country | US
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Telephone | 704-587-7336
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Fax | 704-587-7579
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Provider Business Mailing Address
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Address Line | 11010 S TRYON ST STE 101
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City | CHARLOTTE
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State | NC
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Zip | 28273
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Country | US
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Telephone | 704-587-7336
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Fax | 704-587-7579
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. ROBERT LOUIS YOUNG
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Credential | DDS
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Telephone | 704-587-7336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 7821
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 7797
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License Number State | NC
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