Provider Demographics
NPI:1679618557
Name:YEO, ELIOT M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIOT
Middle Name:M
Last Name:YEO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:34488 YUCAIPA BLVD
Mailing Address - Street 2:#F YUCAIPA FAMILY DENTISTRY
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-2482
Mailing Address - Country:US
Mailing Address - Phone:909-797-0303
Mailing Address - Fax:909-797-8714
Practice Address - Street 1:3410 LA SIERRA AVE
Practice Address - Street 2:#D LA SIERRA FAMILY DENTISTRY
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5205
Practice Address - Country:US
Practice Address - Phone:951-354-9550
Practice Address - Fax:951-354-8644
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA37310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist