Individual
DR. BOBBY YASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1636 N 51ST AVE, PHOENIX, AZ 85035-3936
(602) 904-5901
Mailing address
18408 N 54TH LN, GLENDALE, AZ 85308-1349
(248) 705-8334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010659
AZ
1223G0001X
General Practice Dentistry
D010659
AZ
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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