Provider Demographics
NPI:1467564948
Name:YODER, DAVID EVERETT (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EVERETT
Last Name:YODER
Suffix:
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 1:350 SPARTANBURG HWY
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-1809
Mailing Address - Country:US
Mailing Address - Phone:864-439-0023
Mailing Address - Fax:864-439-9112
Practice Address - Street 1:350 SPARTANBURG HWY
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-1809
Practice Address - Country:US
Practice Address - Phone:864-439-0023
Practice Address - Fax:864-439-9112
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice