MEDICARE: DR. DONNA YOCK 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	35808	CA

General Provider Information

NPI Number	:	1558374918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONNA YOCK DMD

Provider Business Mailing Address
First Line	:	5300 SNYDER LN
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-2915
Country	:	US
Telephone Number	:	707-586-1549
Fax Number	:	707-586-1593

Provider Business Practice Location Address
First Line	:	5300 SNYDER LN STE E
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-2915
Country	:	US
Telephone Number	:	707-586-1549
Fax Number	:	707-586-1593

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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