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General NPI Number Information
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NPI Number | 1811457500
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Entity Type | Organization
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Legal Business Name | MATTHEW S YARBOROUGH DDS INC
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 1020 MAGNOLIA AVE
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City | LARKSPUR
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State | CA
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Zip | 94939-1016
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Country | US
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Telephone | 415-937-1125
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 MAGNOLIA AVE
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City | LARKSPUR
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State | CA
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Zip | 94939-1016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MATTHEW YARBOROUGH
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Credential |
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Telephone | 415-937-1125
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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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