Provider Demographics
NPI:1417719964
Name:YEO DENTAL CORPORATION
Entity Type:Organization
Organization Name:YEO DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:YEO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-873-8299
Mailing Address - Street 1:797 JENEVEIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-4231
Mailing Address - Country:US
Mailing Address - Phone:650-873-8299
Mailing Address - Fax:
Practice Address - Street 1:797 JENEVEIN AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4231
Practice Address - Country:US
Practice Address - Phone:650-873-8299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty