Provider Demographics
NPI:1245296938
Name:YAMAGUCHI, DAVID S (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:YAMAGUCHI
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 1:5678 N PALM AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1850
Mailing Address - Country:US
Mailing Address - Phone:559-440-1411
Mailing Address - Fax:559-440-1412
Practice Address - Street 1:5678 N PALM AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1850
Practice Address - Country:US
Practice Address - Phone:559-440-1411
Practice Address - Fax:559-440-1412
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist