Provider Demographics
NPI:1316385610
Name:YODER, TERRON EUGENE JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERRON
Middle Name:EUGENE
Last Name:YODER
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 OCEAN ISLE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469
Mailing Address - Country:US
Mailing Address - Phone:877-935-5255
Mailing Address - Fax:
Practice Address - Street 1:1525 OCEAN ISLE BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEAN ISLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28469
Practice Address - Country:US
Practice Address - Phone:877-935-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9546122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist