Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 9942 | MD |
NPI | 1093896177 |
---|---|
Provider Name | Dr. Martin Ben Yules |
First Address | White Plains, MD 20695-3432 |
Second Address | Andrews Air Force Base, MD 20762-6600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |