Organization
ROBERT YACKO, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT B YACKO DDS (DENTIST)
(623) 878-3722
Entity
Organization
Contact information
Practice address
6750 W PEORIA AVE, SUITE 134, PEORIA, AZ 85345-9316
(623) 878-3722
(623) 486-8380
Mailing address
6750 W PEORIA AVE, SUITE 134, PEORIA, AZ 85345-9316
(623) 878-3722
(623) 486-8380
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D4166
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D4166
DENTIST TRIENNIAL
AZ
Enumeration date
09/20/2007
Last updated
09/20/2007
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