Individual
MIKE MICHIO YAGAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
12518 SOUTH ST, CERRITOS, CA 90703-7134
(562) 924-0205
Mailing address
12518 SOUTH ST, CERRITOS, CA 90703-7134
(562) 924-0205
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23403
CA
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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