Provider Demographics
NPI:1578761896
Name:YATES, JOSEPH SEAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SEAN
Last Name:YATES
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 1:933 BROADWATER SQ
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1634
Mailing Address - Country:US
Mailing Address - Phone:406-255-1202
Mailing Address - Fax:
Practice Address - Street 1:933 BROADWATER SQ
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1634
Practice Address - Country:US
Practice Address - Phone:406-255-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-08
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2280122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist