Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS039109 | PA |
NPI | 1164782173 |
---|---|
Provider Name | Dr. Jamie M. Yum |
First Address | Allentown, PA 18103-6253 |
Second Address | Allentown, PA 18103-6253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2012 |
Last Update Date | 29/09/2021 |