Provider Demographics
NPI:1821073214
Name:YOUNG, FLOYD E (DDS)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:E
Last Name:YOUNG
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 1:3555 S KINNICKINNIC AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53235-3739
Mailing Address - Country:US
Mailing Address - Phone:414-744-0634
Mailing Address - Fax:414-744-6031
Practice Address - Street 1:3555 S KINNICKINNIC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53235-3739
Practice Address - Country:US
Practice Address - Phone:414-744-0634
Practice Address - Fax:414-744-6031
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4758-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice