Provider Demographics
NPI:1548214091
Name:NOLL, DONNA CORONEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:CORONEL
Last Name:NOLL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 MONARDA PL
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-6717
Mailing Address - Country:US
Mailing Address - Phone:614-861-2629
Mailing Address - Fax:
Practice Address - Street 1:1251 HILL RD N
Practice Address - Street 2:SUITE 103
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9097
Practice Address - Country:US
Practice Address - Phone:614-575-1155
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21768122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist