Provider Demographics
NPI:1477821064
Name:YJZ DENTAL PC
Entity Type:Organization
Organization Name:YJZ DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INS/FINANCIAL CORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-332-7800
Mailing Address - Street 1:18 GONIC RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3925
Mailing Address - Country:US
Mailing Address - Phone:603-332-7800
Mailing Address - Fax:
Practice Address - Street 1:18 GONIC RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3925
Practice Address - Country:US
Practice Address - Phone:603-332-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty