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Organization
JY DENTAL, PLLC
Active
Organization
JY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS YOUNGBLOOD DDS (OWNER)
(432) 553-3886
Entity
Organization
Contact information
Practice address
4410 N MIDKIFF RD, SUITE D-1, MIDLAND, TX 79705-4246
(432) 553-3886
Mailing address
4410 N MIDKIFF RD, SUITE D-1, MIDLAND, TX 79705-4246
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21206
TX
1223P0221X
Pediatric Dentistry
25993
TX
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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