Provider Demographics
NPI:1720218316
Name:YU, DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:YU
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 1:3 VANWOERT AVE
Mailing Address - Street 2:APT #12
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2762
Mailing Address - Country:US
Mailing Address - Phone:516-302-3112
Mailing Address - Fax:
Practice Address - Street 1:1643 COUNTY RD 64
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845
Practice Address - Country:US
Practice Address - Phone:516-302-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist