Individual
MICAH YETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(520) 640-5820
Mailing address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(480) 392-3361
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D010910
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/23/2020
Last updated
02/10/2025
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