Provider Demographics
NPI:1992845507
Name:YANDLE, DAVID KENT (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KENT
Last Name:YANDLE
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 1:5727 ALLIN RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23875-2343
Mailing Address - Country:US
Mailing Address - Phone:804-862-4416
Mailing Address - Fax:804-862-4428
Practice Address - Street 1:5727 ALLIN RD
Practice Address - Street 2:
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-2343
Practice Address - Country:US
Practice Address - Phone:804-862-4416
Practice Address - Fax:804-862-4428
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010056471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice