Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 06348 | IA |
NPI | 1003061052 |
---|---|
Provider Name | Dennis L Yossi |
First Address | Cedar Rapids, IA 52403 |
Second Address | Cedar Rapids, IA 52402-5474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 29/09/2014 |