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General NPI Number Information
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NPI Number | 1790412393
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Entity Type | Organization
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Legal Business Name | PRESCOTT YANG PLLC
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 1959 COMMERCE CENTER CIR STE C
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City | PRESCOTT
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State | AZ
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Zip | 86301-7419
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Country | US
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Telephone | 928-718-1667
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Fax |
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Provider Business Mailing Address
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Address Line | 4732 S DORY TRL
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City | FLAGSTAFF
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State | AZ
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Zip | 86005-8374
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Country | US
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Telephone | 928-814-2420
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID YANG
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Credential | DMD
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Telephone | 928-214-0772
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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 |
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License Number State |
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