Provider Demographics
NPI:1659583078
Name:YUWAY, ANTONIO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:YUWAY
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 1:6201 DR MARTIN LUTHER KING JR ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-5608
Mailing Address - Country:US
Mailing Address - Phone:727-867-7991
Mailing Address - Fax:727-867-1271
Practice Address - Street 1:6201 DR MARTIN LUTHER KING JR ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-5608
Practice Address - Country:US
Practice Address - Phone:727-867-7991
Practice Address - Fax:727-867-1271
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 125771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice