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NPI Code Detail

MEDICARE: ROBERT D.YOUNG DDS PC

MEDICARE: ROBERT D.YOUNG DDS PC
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
11223G0001XGeneral Practice Dentistry2901016748MI

General Provider Information

NPI Number : 1467990127
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT D.YOUNG DDS PC
Provider Business Mailing Address
First Line : 110 W 3RD ST
Second Line :
City : IMLAY CITY
State : MI
Zip : 48444-1096
Country : US
Telephone Number : 810-724-6441
Fax Number :
Provider Business Practice Location Address
First Line : 110 W 3RD ST
Second Line :
City : IMLAY CITY
State : MI
Zip : 48444-1096
Country : US
Telephone Number : 810-724-6441
Fax Number :
Authorized Official
Title or Position : GENERAL DENTIST
Name : DR. ROBERT DARREN YOUNG
Credential : DDS
Telephone Number : 810-724-6441
Provider Enumeration Date : 02/02/2017
Last Update Date : 02/02/2017

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Directions to “ROBERT D.YOUNG DDS PC ” Practice Location

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