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General NPI Number Information
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NPI Number | 1467004341
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Entity Type | Organization
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Legal Business Name | YELENA OBHOLZ DDS II PLLC
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 5101 WISCONSIN AVE NW STE 107B
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City | WASHINGTON
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State | DC
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Zip | 20016-4136
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Country | US
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Telephone | 202-364-8209
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Fax |
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Provider Business Mailing Address
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Address Line | 5101 WISCONSIN AVE NW STE 107B
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City | WASHINGTON
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State | DC
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Zip | 20016-4136
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Country | US
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Telephone | 202-364-8209
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | YELENA OBHOLZ
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Credential | DDS
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Telephone | 202-364-8989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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