Individual
DR. DANIEL PAUL YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
465 MEMORIAL DRIVE, POCATELLO FAMILY DENTISTRY, POCATELLO, ID 83209-8088
(208) 282-6000
(208) 282-5834
Mailing address
ISU - IAGD, CAMPUS BOX 8088, POCATELLO, ID 83209-8088
(208) 282-6000
(208) 282-5834
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4432
ID
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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