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General NPI Number Information
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NPI Number | 1649630948
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Entity Type | Organization
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Legal Business Name | YOO-LEE YEA DDS PLLC
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 18807 BEARDSLEE BLVD SUITE 103
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City | BOTHELL
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State | WA
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Zip | 98011-1712
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Country | US
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Telephone | 425-486-6300
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Fax | 425-487-6498
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Provider Business Mailing Address
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Address Line | 18807 BEARDSLEE BLVD SUITE 103
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City | BOTHELL
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State | WA
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Zip | 98011-1712
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Country | US
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Telephone | 425-486-6300
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Fax | 425-487-6498
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. YOO-LEE YEA
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Credential | DDS MSD MPH
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Telephone | 206-852-7338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DE00009955
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License Number State | WA
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