Provider Demographics
NPI:1861583999
Name:YATES, M ALAN (DMD)
Entity type:Individual
Prefix:
First Name:M
Middle Name:ALAN
Last Name:YATES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:638 NEWTOWN YARDLEY RD
Mailing Address - Street 2:COMMONS WEST PROFESSIONAL BUILDING STE 2A
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-968-6144
Mailing Address - Fax:215-968-7915
Practice Address - Street 1:638 NEWTOWN YARDLEY RD
Practice Address - Street 2:COMMONS WEST PROFESSIONAL BLD STE 2A
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-968-6144
Practice Address - Fax:215-968-7915
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018701-L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T28126Medicare UPIN
YA068696Medicare ID - Type Unspecified