Provider Demographics
NPI:1215257381
Name:YODER, DAVID JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:YODER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 ROSCOE BLVD N
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3625
Mailing Address - Country:US
Mailing Address - Phone:904-673-5869
Mailing Address - Fax:904-267-2291
Practice Address - Street 1:3791 PALM VALLEY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-4182
Practice Address - Country:US
Practice Address - Phone:904-673-5869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist