Provider Demographics
NPI:1790781920
Name:TYNDALL, DONALD A (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:A
Last Name:TYNDALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:135 OLD LYSTRA RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-6330
Mailing Address - Country:US
Mailing Address - Phone:919-967-5476
Mailing Address - Fax:919-966-0705
Practice Address - Street 1:UNC DENTAL FACULTY PRACTICE
Practice Address - Street 2:117 BRAUER HALL, CB #7450
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-843-4655
Practice Address - Fax:919-966-0705
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC48201223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2415389Medicare ID - Type Unspecified
NCU17733Medicare UPIN