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NPI Code Detail

MEDICARE: ML YEO DENTAL CORPORATION

MEDICARE: ML YEO DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist55583CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11215196860OTHERCADENTAL

General Provider Information

NPI Number : 1093101727
Entity Type Code : Organization
Provider Name (Legal Business Name) : ML YEO DENTAL CORPORATION
Provider Business Mailing Address
First Line : 2055 GELLERT BLVD STE 4
Second Line : 1544 JEFFERSON ST STE A
City : DALY CITY
State : CA
Zip : 94015
Country : US
Telephone Number : 650-754-1300
Fax Number :
Provider Business Practice Location Address
First Line : 2055 GELLERT BLVD STE 4
Second Line :
City : DALY CITY
State : CA
Zip : 94015-2814
Country : US
Telephone Number : 650-754-1300
Fax Number :
Authorized Official
Title or Position : CHAIRMAN
Name : MARIA L YEO
Credential : DDS
Telephone Number : 650-591-4704
Provider Enumeration Date : 04/09/2015
Last Update Date : 04/09/2015

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Directions to “ML YEO DENTAL CORPORATION ” Practice Location

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