Provider Demographics
NPI:1285654590
Name:YDRACH, ARTURO ANDRES (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:ANDRES
Last Name:YDRACH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:MR
Other - First Name:ARTURO
Other - Middle Name:YDRACH
Other - Last Name:ANGELET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4420
Mailing Address - Country:US
Mailing Address - Phone:407-932-0883
Mailing Address - Fax:407-932-4251
Practice Address - Street 1:200 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4420
Practice Address - Country:US
Practice Address - Phone:407-932-0883
Practice Address - Fax:407-932-4251
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN150791223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery