Provider Demographics
NPI:1710187885
Name:YOUNG, IAN DYLAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:DYLAN
Last Name:YOUNG
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 1:1445 W 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85220-6348
Mailing Address - Country:US
Mailing Address - Phone:480-452-4293
Mailing Address - Fax:480-833-3336
Practice Address - Street 1:2483 S MARKET ST STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0722
Practice Address - Country:US
Practice Address - Phone:480-857-1044
Practice Address - Fax:480-840-3200
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist