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General NPI Number Information
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NPI Number | 1861704975
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Entity Type | Organization
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Legal Business Name | PRISCILLA YEUNG, DMD, MS, PC
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 2245 W NORTH AVE SUITE C-102
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City | CHICAGO
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State | IL
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Zip | 60647-5723
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Country | US
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Telephone | 847-445-2958
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Fax |
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Provider Business Mailing Address
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Address Line | 2245 W NORTH AVE SUITE C-102
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City | CHICAGO
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State | IL
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Zip | 60647-5723
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Country | US
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Telephone | 847-445-2958
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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. PRISCILLA YEUNG
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Credential | DMD
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Telephone | 847-445-2958
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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 | 021002142
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License Number State | IL
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