Provider Demographics
NPI:1811024458
Name:YATROS, GEORGE S (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:S
Last Name:YATROS
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 1:402 43RD ST W
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2953
Mailing Address - Country:US
Mailing Address - Phone:877-957-6673
Mailing Address - Fax:844-686-4098
Practice Address - Street 1:402 43RD ST W
Practice Address - Street 2:SUITE A
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2953
Practice Address - Country:US
Practice Address - Phone:877-957-6673
Practice Address - Fax:844-686-4098
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN124351223G0001X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13996075024OtherGROUP NPI