Provider Demographics
NPI:1639934565
Name:FRIDAY, YOLANDA EVETTE
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:EVETTE
Last Name:FRIDAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5376
Mailing Address - Country:US
Mailing Address - Phone:972-342-9714
Mailing Address - Fax:
Practice Address - Street 1:420 E PLEASANT RUN RD STE 390
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-1869
Practice Address - Country:US
Practice Address - Phone:469-272-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9931124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist