Provider Demographics
NPI:1295842714
Name:VIGNOLA, ROBERT W (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:VIGNOLA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 SAXER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2334
Mailing Address - Country:US
Mailing Address - Phone:610-328-9878
Mailing Address - Fax:
Practice Address - Street 1:162 SAXER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2334
Practice Address - Country:US
Practice Address - Phone:610-328-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023537L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice