Individual
JEROME NIXON YEOUMANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PA
Contact information
Practice address
7402 YORK ROAD, SUITE 303, TOWSON, MD 21204-7522
(410) 321-1133
(410) 321-0652
Mailing address
6453 CLOISTER GATE DRIVE, TOWSON, MD 21212
(410) 377-0567
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5245
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6790
BLUE CROSS BLUE SHIELD
MD
Enumeration date
12/08/2006
Last updated
07/08/2007
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