Provider Demographics
NPI:1285054825
Name:YARBROUGH, ALFRED N (DDS)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:N
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALFRED
Other - Middle Name:N
Other - Last Name:YARBROUGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1101 EAST JEFFERSON STREET, SUITE 7
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902
Mailing Address - Country:US
Mailing Address - Phone:434-971-7400
Mailing Address - Fax:434-971-7404
Practice Address - Street 1:1101 EAST JEFFERSON STREET, SUITE 7
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902
Practice Address - Country:US
Practice Address - Phone:434-971-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA35621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice