Provider Demographics
NPI:1396704607
Name:JOHN F. YOUNG, DMD, PSC
Entity type:Organization
Organization Name:JOHN F. YOUNG, DMD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-525-7586
Mailing Address - Street 1:7033 BURLINGTON PIKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5150
Mailing Address - Country:US
Mailing Address - Phone:859-525-7586
Mailing Address - Fax:859-647-3712
Practice Address - Street 1:7033 BURLINGTON PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5150
Practice Address - Country:US
Practice Address - Phone:859-525-7586
Practice Address - Fax:859-647-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty