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General NPI Number Information
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NPI Number | 1093101727
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Entity Type | Organization
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Legal Business Name | ML YEO DENTAL CORPORATION
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 2055 GELLERT BLVD STE 4
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City | DALY CITY
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State | CA
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Zip | 94015-2814
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Country | US
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Telephone | 650-754-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 2055 GELLERT BLVD STE 4 1544 JEFFERSON ST STE A
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City | DALY CITY
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State | CA
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Zip | 94015
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Country | US
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Telephone | 650-754-1300
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MARIA L YEO
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Credential | DDS
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Telephone | 650-591-4704
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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 | 55583
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License Number State | CA
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