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General NPI Number Information
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NPI Number | 1235495920
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Entity Type | Individual
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Provider Name | SHERRI LYNN YOUNG D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 04/06/2012
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Provider Practice Location Address
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Address Line | 130 MARVIN RD SE SUITE 201
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City | LACEY
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State | WA
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Zip | 98503
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Country | US
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Telephone | 360-456-7070
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Fax | 360-456-2892
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Provider Business Mailing Address
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Address Line | 130 MARVIN RD SE SUITE 201
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City | LACEY
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State | WA
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Zip | 98503
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Country | US
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Telephone | 360-456-7070
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Fax | 360-456-2892
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00009199
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License Number State | WA
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