Provider Demographics
NPI:1740407477
Name:YEE, MICHAEL HACKMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HACKMAN
Last Name:YEE
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 1:9119 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6560
Mailing Address - Country:US
Mailing Address - Phone:714-963-2993
Mailing Address - Fax:
Practice Address - Street 1:9119 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6560
Practice Address - Country:US
Practice Address - Phone:714-963-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice