Provider Demographics
NPI:1205832748
Name:CADLE, DONALD I (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:I
Last Name:CADLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5823 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-2713
Mailing Address - Country:US
Mailing Address - Phone:727-842-6052
Mailing Address - Fax:727-843-8338
Practice Address - Street 1:5823 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-2713
Practice Address - Country:US
Practice Address - Phone:727-842-6052
Practice Address - Fax:727-843-8338
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL55451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice