Provider Demographics
NPI:1609054758
Name:JOSEPH D YATES DDS PA
Entity Type:Organization
Organization Name:JOSEPH D YATES DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:662-494-1700
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-0695
Mailing Address - Country:US
Mailing Address - Phone:662-494-1700
Mailing Address - Fax:662-494-1407
Practice Address - Street 1:605 E WESTBROOK STREET
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-0695
Practice Address - Country:US
Practice Address - Phone:662-494-1700
Practice Address - Fax:662-494-1407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPH D YATES DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1531721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty