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General NPI Number Information
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NPI Number | 1871718031
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Entity Type | Organization
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Legal Business Name | YEOU-DER JAN ,DDS
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Dates
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Enumeration Date | 04/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1480 S HARBOR BLVD STE 3
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City | LA HABRA
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State | CA
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Zip | 90631-7562
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Country | US
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Telephone | 714-525-1151
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Fax | 714-525-1152
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Provider Business Mailing Address
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Address Line | 1480 S HARBOR BLVD STE 3
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City | LA HABRA
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State | CA
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Zip | 90631-7562
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Country | US
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Telephone | 714-525-1151
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Fax | 714-525-1152
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Authorized Official
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Title or Position | PARTNER
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Name | DR. YEOU-DER JAN
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Credential | DDS
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Telephone | 714-525-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D35409
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License Number State | CA
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