Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 3693 | WV |
NPI | 1003917584 |
---|---|
Provider Name | Adeline Yuh |
First Address | Bridgeport, WV 26330-1668 |
Second Address | Bridgeport, WV 26330-1668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |