Provider Demographics
NPI:1992822787
Name:KENNETH J. YOST, DMD,PA
Entity Type:Organization
Organization Name:KENNETH J. YOST, DMD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-477-1888
Mailing Address - Street 1:1407 FOULK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2762
Mailing Address - Country:US
Mailing Address - Phone:302-477-1888
Mailing Address - Fax:302-477-1845
Practice Address - Street 1:1407 FOULK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2762
Practice Address - Country:US
Practice Address - Phone:302-477-1888
Practice Address - Fax:302-477-1845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00000989261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty