Provider Demographics
NPI:1649326133
Name:YANNOTTY, CARL THOMAS JR (DMD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:THOMAS
Last Name:YANNOTTY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 STIRLING VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-6730
Mailing Address - Country:US
Mailing Address - Phone:724-283-8210
Mailing Address - Fax:724-283-9310
Practice Address - Street 1:110 STIRLING VILLAGE DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-6730
Practice Address - Country:US
Practice Address - Phone:724-283-8210
Practice Address - Fax:724-283-9310
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024937L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice