Provider Demographics
NPI:1386866275
Name:YOUNG, TODD ALVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALVIN
Last Name:YOUNG
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 1:444 WEST MINER ST
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-2839
Mailing Address - Country:US
Mailing Address - Phone:530-842-7323
Mailing Address - Fax:530-842-4320
Practice Address - Street 1:444 WEST MINER ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-2839
Practice Address - Country:US
Practice Address - Phone:530-842-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist