Provider Demographics
NPI:1932550431
Name:YANOSKY ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:YANOSKY ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:YANOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-870-1444
Mailing Address - Street 1:1651 INDEPENDENCE CT
Mailing Address - Street 2:SUITE 141
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4173
Mailing Address - Country:US
Mailing Address - Phone:205-870-1444
Mailing Address - Fax:
Practice Address - Street 1:1651 INDEPENDENCE CT
Practice Address - Street 2:SUITE 141
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4173
Practice Address - Country:US
Practice Address - Phone:205-870-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-26
Last Update Date:2016-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL50311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty