Provider Demographics
NPI:1336767862
Name:YU, MILO JINHO (DMD)
Entity type:Individual
Prefix:DR
First Name:MILO JINHO
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 MOLLY BANISTER DRIVE
Mailing Address - Street 2:#177
Mailing Address - City:RED DEER
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T4R 1N9
Mailing Address - Country:CM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4900 MOLLY BANISTER DR
Practice Address - Street 2:#177
Practice Address - City:RED DEER
Practice Address - State:AB
Practice Address - Zip Code:T4R 1N9
Practice Address - Country:CA
Practice Address - Phone:403-347-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0428101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice