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General NPI Number Information
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NPI Number | 1962060194
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Entity Type | Individual
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Provider Name | DANIEL JONE YOUNG DMD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 4516 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90807-1513
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Country | US
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Telephone | 562-437-0647
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 PASO REAL AVE
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3840
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Country | US
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Telephone | 626-709-7670
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 103729
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License Number State | CA
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