Provider Demographics
NPI:1023338845
Name:ROLAND, DONALD E JR (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:ROLAND
Suffix:JR
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3233
Mailing Address - Country:US
Mailing Address - Phone:610-326-7880
Mailing Address - Fax:
Practice Address - Street 1:500 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3233
Practice Address - Country:US
Practice Address - Phone:610-326-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2018-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD458839204E00000X
PADS037996204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery