Provider Demographics
NPI:1740498591
Name:DYCOCO-ESGUERRA, YOLANDA BULAON (DMD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:BULAON
Last Name:DYCOCO-ESGUERRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:YOLANDA
Other - Middle Name:BULAON
Other - Last Name:DYCOCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:546 WEST BADILLO STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722
Mailing Address - Country:US
Mailing Address - Phone:626-974-9382
Mailing Address - Fax:626-737-0665
Practice Address - Street 1:546 WEST BADILLO STREET
Practice Address - Street 2:SUITE E
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722
Practice Address - Country:US
Practice Address - Phone:626-974-9382
Practice Address - Fax:626-737-0665
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA434381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice