Provider Demographics
NPI:1306990148
Name:YEN, SHURLANG (DMD)
Entity type:Individual
Prefix:DR
First Name:SHURLANG
Middle Name:
Last Name:YEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 CENTERVILLE HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6115
Mailing Address - Country:US
Mailing Address - Phone:770-972-2888
Mailing Address - Fax:770-972-3880
Practice Address - Street 1:3321 CENTERVILLE HWY
Practice Address - Street 2:STE B
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6115
Practice Address - Country:US
Practice Address - Phone:770-972-2888
Practice Address - Fax:770-972-3880
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0115941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice