Provider Demographics
NPI:1356565998
Name:KROLL, YALE JESSE (DDS)
Entity type:Individual
Prefix:DR
First Name:YALE
Middle Name:JESSE
Last Name:KROLL
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 1:95 CHURCH ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1515
Mailing Address - Country:US
Mailing Address - Phone:914-686-3533
Mailing Address - Fax:914-949-2453
Practice Address - Street 1:95 CHURCH ST
Practice Address - Street 2:SUITE 406
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1515
Practice Address - Country:US
Practice Address - Phone:914-686-3533
Practice Address - Fax:914-949-2453
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA034573-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics