Provider Demographics
NPI:1649741190
Name:DR. GEORGE M YELLICH DDS MS INC
Entity Type:Organization
Organization Name:DR. GEORGE M YELLICH DDS MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YELLICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:408-858-3051
Mailing Address - Street 1:552 MONHOLLAN RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9459
Mailing Address - Country:US
Mailing Address - Phone:408-242-6548
Mailing Address - Fax:
Practice Address - Street 1:950 CASS ST STE A
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4547
Practice Address - Country:US
Practice Address - Phone:831-718-8140
Practice Address - Fax:831-920-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty