Provider Demographics
NPI:1144986019
Name:JEFFREY YELLE PLLC
Entity type:Organization
Organization Name:JEFFREY YELLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-441-2158
Mailing Address - Street 1:18925 BASE CAMP RD
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-3414
Mailing Address - Country:US
Mailing Address - Phone:719-488-2375
Mailing Address - Fax:
Practice Address - Street 1:18925 BASE CAMP RD
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-3414
Practice Address - Country:US
Practice Address - Phone:719-488-2375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental