Provider Demographics
NPI:1295896306
Name:MA, YAT HO (DDS)
Entity type:Individual
Prefix:DR
First Name:YAT HO
Middle Name:
Last Name:MA
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:CMR 422
Mailing Address - Street 2:BOX 1345
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09067
Mailing Address - Country:US
Mailing Address - Phone:06371-617-9217
Mailing Address - Fax:
Practice Address - Street 1:CMR 422
Practice Address - Street 2:BOX 1345
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09067-0014
Practice Address - Country:US
Practice Address - Phone:000000-000-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052226-1122300000X
NY0522261223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist