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General NPI Number Information
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NPI Number | 1598140964
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Entity Type | Organization
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Legal Business Name | YES DENTAL
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 2530 N 8TH ST STE 101
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8856
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Country | US
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Telephone | 970-241-4937
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Fax |
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Provider Business Mailing Address
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Address Line | 2530 N 8TH ST STE 101
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8856
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | NATHAN MCKNIGHT
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Credential | D.D.S.
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Telephone | 970-241-4937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DEN.00202600
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License Number State | CO
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