Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 18196 | MA |
NPI | 1205987641 |
---|---|
Provider Name | Dr. Hideo Yamamoto |
First Address | Newton Centre, MA 02459-2454 |
Second Address | Newton Centre, MA 02459-2454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2007 |
Last Update Date | 08/07/2007 |