Organization
HEIDI D. YANG, DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI YANG DMD (PRESIDENT)
(502) 426-0705
Entity
Organization
Contact information
Practice address
7807 SHELBYVILLE RD STE 203, LOUISVILLE, KY 40222
(502) 426-0705
Mailing address
7807 SHELBYVILLE RD STE 203, LOUISVILLE, KY 40222-9000
(502) 426-0705
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
07451
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60074515
—
KY
Enumeration date
03/15/2012
Last updated
06/27/2018
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