Provider Demographics
NPI:1285980532
Name:YES DENTAL INC
Entity type:Organization
Organization Name:YES DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-241-4937
Mailing Address - Street 1:2530 N 8TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8856
Mailing Address - Country:US
Mailing Address - Phone:970-241-4937
Mailing Address - Fax:970-241-3605
Practice Address - Street 1:2530 N 8TH ST STE 101
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8856
Practice Address - Country:US
Practice Address - Phone:970-241-4937
Practice Address - Fax:970-241-3605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO102341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67431763Medicaid