Fudah Young | Ann Arbor, MI • PECOS Search

Fudah Young

Dentist

Dental Providers

1616 Packard St, Ann Arbor, MI 48104-4455

PECOS Enrollment

Based on the most recent information from CMS, provider Fudah Young does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1407901317
Provider Type
Individual
Full Name
Young, Fudah
Title
Dr.
Credential
D.D.S.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
1/24/2007
Last Updated
7/8/2007

Contact Information

Practice Location

1616 Packard St, Ann Arbor, MI 48104-4455

Unlisted Fax

Mailing Location

1616 Packard St, Ann Arbor, MI 48104-4455

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 2901011883 Michigan