Provider Demographics
NPI:1720099914
Name:YEH, MATTHEW (BDS MSPH MS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:YEH
Suffix:
Gender:M
Credentials:BDS MSPH MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-0966
Mailing Address - Country:US
Mailing Address - Phone:360-676-9222
Mailing Address - Fax:360-676-9223
Practice Address - Street 1:2141 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9183
Practice Address - Country:US
Practice Address - Phone:360-676-9222
Practice Address - Fax:360-676-9223
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000094701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics