Provider Demographics
NPI:1497778294
Name:YOUNG, PHILIP J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
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 1:6715 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1485
Mailing Address - Country:US
Mailing Address - Phone:716-568-9999
Mailing Address - Fax:
Practice Address - Street 1:6715 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1485
Practice Address - Country:US
Practice Address - Phone:716-568-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048066-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist