Provider Demographics
NPI:1619220852
Name:DON EDWARD ABEL DDS PC
Entity Type:Organization
Organization Name:DON EDWARD ABEL DDS PC
Other - Org Name:PRAIRELAND DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:E
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-392-7481
Mailing Address - Street 1:635 W ELM ST
Mailing Address - Street 2:PO BOX 296
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-1620
Mailing Address - Country:US
Mailing Address - Phone:618-392-7481
Mailing Address - Fax:
Practice Address - Street 1:635 W ELM ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-1620
Practice Address - Country:US
Practice Address - Phone:618-392-7481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060002438261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental