Provider Demographics
NPI:1497132955
Name:DAVID W YATES DMD PC
Entity Type:Organization
Organization Name:DAVID W YATES DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNET/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WARD
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-776-6177
Mailing Address - Street 1:5520 PGA BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3981
Mailing Address - Country:US
Mailing Address - Phone:561-776-6177
Mailing Address - Fax:561-776-3745
Practice Address - Street 1:5520 PGA BLVD
Practice Address - Street 2:STE 208
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3981
Practice Address - Country:US
Practice Address - Phone:561-776-6177
Practice Address - Fax:561-776-3745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16095332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment