Provider Demographics
NPI:1457432155
Name:YATES, DAVID WARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WARD
Last Name:YATES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 PGA BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3981
Mailing Address - Country:US
Mailing Address - Phone:561-776-6177
Mailing Address - Fax:561-776-3745
Practice Address - Street 1:5520 PGA BLVD
Practice Address - Street 2:STE 208
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3981
Practice Address - Country:US
Practice Address - Phone:561-776-6177
Practice Address - Fax:561-776-3745
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN160951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice