Provider Demographics
NPI:1447957238
Name:YELLOWSTONE DENTAL PLLC
Entity type:Organization
Organization Name:YELLOWSTONE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARPITKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-760-4293
Mailing Address - Street 1:2251 FM 646 RD W STE 150
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-3255
Mailing Address - Country:US
Mailing Address - Phone:765-760-4293
Mailing Address - Fax:
Practice Address - Street 1:2251 FM 646 RD W STE 150
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3255
Practice Address - Country:US
Practice Address - Phone:765-760-4293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental