Provider Demographics
NPI:1962554980
Name:YARBROUGH, JOHN CLYDE (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLYDE
Last Name:YARBROUGH
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 1:2321 WHITESBURG DR S
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3819
Mailing Address - Country:US
Mailing Address - Phone:256-539-2242
Mailing Address - Fax:256-539-9809
Practice Address - Street 1:2321 WHITESBURG DR S
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3819
Practice Address - Country:US
Practice Address - Phone:256-539-2242
Practice Address - Fax:256-539-9809
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist