Provider Demographics
NPI:1669577847
Name:YANT, WILLIAM R (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:YANT
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 1:15703 GARRETT HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-4030
Mailing Address - Country:US
Mailing Address - Phone:301-334-2225
Mailing Address - Fax:301-334-2331
Practice Address - Street 1:15703 GARRETT HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-4030
Practice Address - Country:US
Practice Address - Phone:301-334-2225
Practice Address - Fax:301-334-2331
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice