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General NPI Number Information
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NPI Number | 1649644352
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Entity Type | Organization
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Legal Business Name | B R YATES, DMD
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 810 CHEVY CHASE PL
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City | LEXINGTON
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State | KY
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Zip | 40502-2144
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Country | US
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Telephone | 859-699-9509
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Fax |
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Provider Business Mailing Address
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Address Line | 252 HANNAH TODD PL
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City | LEXINGTON
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State | KY
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Zip | 40509-9026
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Country | US
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Telephone | 859-699-9509
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. BRANDI YATES
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Credential | DMD
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Telephone | 859-699-9509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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