MEDICARE: YEE L YANG DMD

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	122300000X	Dentist	AR3453	AR

General Provider Information

NPI Number	:	1235465303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEE L YANG DMD

Provider Business Mailing Address
First Line	:	PO BOX 669
Second Line	:
City	:	MARIANNA
State	:	AR
Zip	:	72360-0669
Country	:	US
Telephone Number	:	870-295-5225
Fax Number	:	870-295-6900

Provider Business Practice Location Address
First Line	:	530 ATKINS BLVD
Second Line	:
City	:	MARIANNA
State	:	AR
Zip	:	72360-2113
Country	:	US
Telephone Number	:	870-295-5225
Fax Number	:	870-295-6900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2009
Last Update Date	:	10/26/2009

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