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General NPI Number Information
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NPI Number | 1932115037
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Entity Type | Individual
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Provider Name | MICHAEL ANDREW YACKO II D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1310 24TH AVE S 160
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City | NASHVILLE
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State | TN
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Zip | 37212-2637
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Country | US
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Telephone | 615-327-5321
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Fax | 615-321-6331
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Provider Business Mailing Address
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Address Line | 1010 PERKINS LN
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City | FRANKLIN
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State | TN
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Zip | 37069-4734
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Country | US
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Telephone | 615-790-9592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 328371
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License Number State | TN
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