Individual
JOHN M IASELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
410 S 12 AVENUE, YAKIMA, WA 98902
(509) 452-7115
(509) 452-8260
Mailing address
410 S 12 AVENUE, YAKIMA, WA 98902
(509) 452-7115
(509) 452-8260
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DE00009364
WA
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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