Provider Demographics
NPI:1558521930
Name:SY DENTISTRY DMD PC
Entity Type:Organization
Organization Name:SY DENTISTRY DMD PC
Other - Org Name:SHURLANG YEN
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHURLANG
Authorized Official - Middle Name:
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-972-2888
Mailing Address - Street 1:3321 HWY 123
Mailing Address - Street 2:SUITE B
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039
Mailing Address - Country:US
Mailing Address - Phone:770-972-2888
Mailing Address - Fax:770-972-3880
Practice Address - Street 1:3321 HWY 124
Practice Address - Street 2:SUITE B
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6115
Practice Address - Country:US
Practice Address - Phone:770-972-2888
Practice Address - Fax:770-972-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty