Provider Demographics
NPI:1093896177
Name:YULES, MARTIN BEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:BEN
Last Name:YULES
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 1:8300 HIGHGROVE CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3432
Mailing Address - Country:US
Mailing Address - Phone:301-638-1873
Mailing Address - Fax:
Practice Address - Street 1:1601 CALIFORNIA AVE
Practice Address - Street 2:79 DS/SGDD
Practice Address - City:ANDREWS AIR FORCE BASE
Practice Address - State:MD
Practice Address - Zip Code:20762-6600
Practice Address - Country:US
Practice Address - Phone:240-857-5029
Practice Address - Fax:240-857-7561
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD99421223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics