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General NPI Number Information
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NPI Number | 1912062449
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Entity Type | Organization
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Legal Business Name | MICHAEL L. YANG, D.D.S., LLC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 WESTBURY DR #230
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2541
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Country | US
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Telephone | 636-947-1057
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Fax | 636-723-1627
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Provider Business Mailing Address
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Address Line | ONE WESTBURY SQUARE #230
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City | ST. CHARLES
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State | MO
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Zip | 63301
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Country | US
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Telephone | 636-947-1057
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Fax | 636-723-1627
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL LEO YANG
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Credential | D.D.S.
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Telephone | 636-947-1057
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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 | 014666
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License Number State | MO
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