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General NPI Number Information
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NPI Number | 1417318940
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Entity Type | Individual
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Provider Name | MILES YARBROUGH D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2016
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Last Update Date | 10/18/2018
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Provider Practice Location Address
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Address Line | 1430 JOHN WESLEY GILBERT DR
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City | AUGUSTA
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State | GA
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Zip | 30912-0001
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Country | US
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Telephone | 706-721-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 7 S STILLWOOD CT
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City | SAVANNAH
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State | GA
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Zip | 31419-2737
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Country | US
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Telephone | 912-272-5920
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN015389
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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