Provider Demographics
NPI:1265422745
Name:YUEN, WILSON MING (DDS)
Entity type:Individual
Prefix:DR
First Name:WILSON
Middle Name:MING
Last Name:YUEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3452 GRAVINA PL
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6272
Mailing Address - Country:US
Mailing Address - Phone:925-516-8793
Mailing Address - Fax:925-516-4251
Practice Address - Street 1:1155 2ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2285
Practice Address - Country:US
Practice Address - Phone:925-516-8793
Practice Address - Fax:925-516-4251
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADI0338861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice