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General NPI Number Information
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NPI Number | 1245569227
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Entity Type | Organization
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Legal Business Name | XINHAI YANG, DMD
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 12/21/2009
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Provider Practice Location Address
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Address Line | 1842 BEACON ST SUITE 306
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City | BROOKLINE
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State | MA
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Zip | 02445-1930
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Country | US
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Telephone | 617-264-9966
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Fax | 781-694-0018
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Provider Business Mailing Address
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Address Line | 2 INTERVALE RD
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City | WELLESLEY
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State | MA
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Zip | 02481-1606
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Country | US
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Telephone | 617-686-0944
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Fax | 781-694-0018
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Authorized Official
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Title or Position | OWNER
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Name | DR. XINHAI YANG
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Credential | DMD
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Telephone | 617-686-0944
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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 | 21878
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License Number State | MA
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