Provider Demographics
NPI:1104093897
Name:YU, CAROLYN L (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:L
Last Name:YU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1430 TARA HILLS DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2580
Mailing Address - Country:US
Mailing Address - Phone:510-724-8001
Mailing Address - Fax:510-724-1930
Practice Address - Street 1:1430 TARA HILLS DR
Practice Address - Street 2:SUITE C
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2580
Practice Address - Country:US
Practice Address - Phone:510-724-8001
Practice Address - Fax:510-724-1930
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA531151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice