Provider Demographics
NPI:1396909115
Name:YARBROUGH, RONALD JR (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:YARBROUGH
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:RON
Other - Middle Name:
Other - Last Name:YARBROUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:16688 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1400
Mailing Address - Country:US
Mailing Address - Phone:813-749-7116
Mailing Address - Fax:813-333-7323
Practice Address - Street 1:16688 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1400
Practice Address - Country:US
Practice Address - Phone:813-749-7116
Practice Address - Fax:813-333-7323
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL53551223X0400X
NY0523351223X0400X
FLDN 184451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics