Organization
DR. ROBERT B. YACKO D.D.S.; P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT B YACKO D.D.S. (DENTIST)
(623) 878-3722
Entity
Organization
Contact information
Practice address
6750 W PEORIA AVE STE 134, PEORIA, AZ 85345-9320
(623) 878-3722
Mailing address
6750 W PEORIA AVE STE 134, PEORIA, AZ 85345-9320
(623) 878-3722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945033
—
AZ
Enumeration date
12/31/2015
Last updated
12/31/2015
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