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Organization
TOM YAN DDS PC
Active
Organization
TOM YAN DDS PC
Active
Other names
FiDi Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENTAO YAN DDS (PRESIDENT)
(212) 742-2070
Entity
Organization
Contact information
Practice address
125 MAIDEN LN FL 17B, NEW YORK, NY 10038-4960
(212) 742-2070
Mailing address
125 MAIDEN LN FL 17B, NEW YORK, NY 10038-4960
(212) 742-2070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225287774
DENTIST
NY
Enumeration date
09/02/2022
Last updated
09/02/2022
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