Provider Demographics
NPI:1619023785
Name:YBANEZ, DANILO G (DMD)
Entity Type:Individual
Prefix:
First Name:DANILO
Middle Name:G
Last Name:YBANEZ
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 1:13 FIELDBROOK DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7742
Mailing Address - Country:US
Mailing Address - Phone:609-653-2171
Mailing Address - Fax:
Practice Address - Street 1:15 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1613
Practice Address - Country:US
Practice Address - Phone:609-465-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022610001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice