Provider Demographics
NPI:1316004567
Name:ENDY, DONNA L (DMD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:ENDY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1110
Mailing Address - Country:US
Mailing Address - Phone:215-536-7705
Mailing Address - Fax:215-536-7740
Practice Address - Street 1:1500 LOCUST ST
Practice Address - Street 2:SUITE 1408
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4329
Practice Address - Country:US
Practice Address - Phone:215-732-4450
Practice Address - Fax:215-735-9886
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0354841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics