| Yadira Cardona-rohena, Dmd | |
|
4285 Jim Moore Rd Bldg 100, Suite 104 Dacula GA 30019-1609 | |
| (678) 835-1135 | |
| (678) 835-1136 |
| Full Name | Yadira Cardona-rohena, Dmd |
|---|---|
| Speciality | Dentist |
| Location | 4285 Jim Moore Rd, Dacula, Georgia |
| Authorized Official Name and Position | Yadira Cardona-rohena (OWNER AND DOCTOR) |
| Authorized Official Contact | 6788351135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yadira Cardona-rohena, Dmd 4285 Jim Moore Rd Bldg 100, Suite 104 Dacula GA 30019-1609 Ph: (678) 835-1135 | Yadira Cardona-rohena, Dmd 4285 Jim Moore Rd Bldg 100, Suite 104 Dacula GA 30019-1609 Ph: (678) 835-1135 |
| NPI Number | 1437412889 |
|---|---|
| Provider Enumeration Date | 06/20/2012 |
| Last Update Date | 06/27/2020 |
| Medicare PECOS PAC ID | 1456503853 |
|---|---|
| Medicare Enrollment ID | O20121211000460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437412889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN013477 (Georgia) | Primary |
| Provider Name | Yadira Nmi Cardona Rohena |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1790834083 PECOS PAC ID: 7012008865 Enrollment ID: I20070808000220 |
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