Provider Demographics
NPI:1154490076
Name:YAMILETH MONTOYA PATE DDS PLLC
Entity Type:Organization
Organization Name:YAMILETH MONTOYA PATE DDS PLLC
Other - Org Name:PATE FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YAMILETH
Authorized Official - Middle Name:MONTOYA
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-254-8111
Mailing Address - Street 1:2618 SE J ST SUITE 6
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712
Mailing Address - Country:US
Mailing Address - Phone:479-254-8111
Mailing Address - Fax:479-254-8112
Practice Address - Street 1:2618 SE J ST SUITE 6
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712
Practice Address - Country:US
Practice Address - Phone:479-254-8111
Practice Address - Fax:479-254-8112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR33021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty