MEDICARE: PHILIP L. YOUNTS, D.D.S., INC.

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
1	1223G0001X	General Practice Dentistry	30018561	OH

General Provider Information

NPI Number	:	1144494667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILIP L. YOUNTS, D.D.S., INC.

Provider Business Mailing Address
First Line	:	3744 APPLEGATE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-5402
Country	:	US
Telephone Number	:	513-661-5013
Fax Number	:	513-661-2802

Provider Business Practice Location Address
First Line	:	3744 APPLEGATE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-5402
Country	:	US
Telephone Number	:	513-661-5013
Fax Number	:	513-661-2802

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PHILIP L YOUNTS
Credential	:	D.D.S.
Telephone Number	:	513-661-5013

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	04/16/2008

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