Provider Demographics
NPI:1598068066
Name:YOUNT, BEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:
Last Name:YOUNT
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 1:720 N EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3714
Mailing Address - Country:US
Mailing Address - Phone:650-344-7888
Mailing Address - Fax:650-348-1330
Practice Address - Street 1:720 N EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3714
Practice Address - Country:US
Practice Address - Phone:650-344-7888
Practice Address - Fax:650-348-1330
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA587691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice