Provider Demographics
NPI:1760442487
Name:YOUNG, JOHN F (DMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
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 1:7033 BURLINGTON PIKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5150
Mailing Address - Country:US
Mailing Address - Phone:859-525-7586
Mailing Address - Fax:859-647-3712
Practice Address - Street 1:7033 BURLINGTON PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5150
Practice Address - Country:US
Practice Address - Phone:859-525-7586
Practice Address - Fax:859-647-3712
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist