Provider Demographics
NPI:1366732745
Name:PETER YOUNG D D S INC
Entity type:Organization
Organization Name:PETER YOUNG D D S INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-445-2536
Mailing Address - Street 1:301 W HUNTINGTON DR STE 217
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-1529
Mailing Address - Country:US
Mailing Address - Phone:626-445-2536
Mailing Address - Fax:626-445-0127
Practice Address - Street 1:301 W HUNTINGTON DR STE 217
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-1529
Practice Address - Country:US
Practice Address - Phone:626-445-2536
Practice Address - Fax:626-445-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty