Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 5001949 | WI |
Y | 1223P0700X | Prosthodontist | DS041151 | PA |
NPI | 1194932095 |
---|---|
Provider Name | Yvonne Hart |
First Address | Wayne, PA 19087-2210 |
Second Address | Phoenixville, PA 19460-5202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 28/10/2019 |