Provider Demographics
NPI:1194932095
Name:HART, YVONNE (DDS, MS)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 BROWER RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2210
Mailing Address - Country:US
Mailing Address - Phone:262-227-1608
Mailing Address - Fax:
Practice Address - Street 1:300 SCHUYLKILL RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-5202
Practice Address - Country:US
Practice Address - Phone:610-933-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0411511223P0700X
WI50019491223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics