Provider Demographics
NPI:1295949618
Name:PETER C YANES DDS INC
Entity type:Organization
Organization Name:PETER C YANES DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:YANES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-466-4495
Mailing Address - Street 1:7365 CARNELIAN ST
Mailing Address - Street 2:STE 236
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730
Mailing Address - Country:US
Mailing Address - Phone:909-466-4495
Mailing Address - Fax:909-466-4498
Practice Address - Street 1:7365 CARNELIAN ST
Practice Address - Street 2:STE 236
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-466-4495
Practice Address - Fax:909-466-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty