Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 04464 | NH |
N | 1223P0300X | Periodontist | DS040366 | PA |
NPI | 1093184616 |
---|---|
Provider Name | Dr. Howard Yen |
First Address | Keene, NH 03431-3970 |
Second Address | Keene, NH 03431-1773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2015 |
Last Update Date | 22/06/2019 |