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General NPI Number Information
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NPI Number | 1679904304
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Entity Type | Organization
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Legal Business Name | LINDSAY C YANCEY JR DDS, PC
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 12/05/2013
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Provider Practice Location Address
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Address Line | 481 SHEPHERD ST
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1627
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Country | US
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Telephone | 336-768-8850
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Fax | 336-768-0135
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Provider Business Mailing Address
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Address Line | 481 SHEPHERD ST
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1627
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Country | US
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Telephone | 336-768-8850
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Fax | 336-768-0135
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDSAY C YANCEY JR.
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Credential | DDS
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Telephone | 336-768-8850
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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 | 4458
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License Number State | NC
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