MEDICARE: DR. LISA YERKE D.D.S., M.S.

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	1223P0300X	Periodontics	054387	NY

General Provider Information

NPI Number	:	1912005315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA YERKE D.D.S., M.S.

Provider Business Mailing Address
First Line	:	9 SPINDRIFT CT APT 6
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-7850
Country	:	US
Telephone Number	:	585-474-5377
Fax Number	:

Provider Business Practice Location Address
First Line	:	6489 TRANSIT RD
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-1427
Country	:	US
Telephone Number	:	716-626-4427
Fax Number	:

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	06/25/2019

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