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General NPI Number Information
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NPI Number | 1558521930
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Entity Type | Organization
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Legal Business Name | SY DENTISTRY DMD PC
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 3321 HWY 124 SUITE B
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City | SNELLVILLE
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State | GA
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Zip | 30039-6115
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Country | US
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Telephone | 770-972-2888
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Fax | 770-972-3880
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Provider Business Mailing Address
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Address Line | 3321 HWY 123 SUITE B
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City | SNELLVILLE
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State | GA
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Zip | 30039
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Country | US
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Telephone | 770-972-2888
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Fax | 770-972-3880
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SHURLANG YEN
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Credential | DMD
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Telephone | 770-972-2888
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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 |
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License Number State |
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