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General NPI Number Information
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NPI Number | 1710431747
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Entity Type | Individual
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Provider Name | MARIA HADI YEATON DDS
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Gender | Female
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 10445 LAUREL CANYON BLVD
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City | PACOIMA
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State | CA
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Zip | 91331-3605
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Country | US
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Telephone | 818-890-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 1997 MARCO DR
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City | CAMARILLO
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State | CA
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Zip | 93010-2433
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Country | US
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Telephone | 714-757-3702
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 100537
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License Number State | CA
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