Provider Demographics
NPI:1265591424
Name:TABANGAY, YVETTE MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:MARIE
Last Name:TABANGAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WEST BIG BEAVER
Mailing Address - Street 2:STE 100A
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304
Mailing Address - Country:US
Mailing Address - Phone:248-290-2900
Mailing Address - Fax:248-290-2904
Practice Address - Street 1:50 WEST BIG BEAVER
Practice Address - Street 2:STE 100A
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304
Practice Address - Country:US
Practice Address - Phone:248-290-2900
Practice Address - Fax:248-290-2904
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice