| NPI | 1437231503 |
|---|---|
| Former Name | JAY SCOTT YUDELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: OR D11182) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 13269) |
| 1223G0001X Dentist, General Practice (Licence: CO 202368) | |
| 1223G0001X Dentist, General Practice (Licence: NY 044249) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-12-31 |