Provider Demographics
NPI:1821565227
Name:HYANNIS FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HYANNIS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-868-6445
Mailing Address - Street 1:39 GATSBY DR APT H
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-8000
Mailing Address - Country:US
Mailing Address - Phone:770-868-6445
Mailing Address - Fax:
Practice Address - Street 1:725 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3422
Practice Address - Country:US
Practice Address - Phone:508-775-8769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty