Provider Demographics
NPI:1083611529
Name:YOST, CLYDE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLYDE
Middle Name:
Last Name:YOST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PALO ALTO RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3772
Mailing Address - Country:US
Mailing Address - Phone:210-924-8770
Mailing Address - Fax:210-921-9650
Practice Address - Street 1:102 PALO ALTO RD
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3772
Practice Address - Country:US
Practice Address - Phone:210-924-8770
Practice Address - Fax:210-921-9650
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120921223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry