Provider Demographics
NPI:1265403232
Name:YANDELL, DONALD L (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:YANDELL
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 1:3608 ALTA MESA BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-5641
Mailing Address - Country:US
Mailing Address - Phone:817-294-0877
Mailing Address - Fax:817-294-0894
Practice Address - Street 1:3608 ALTA MESA BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-5641
Practice Address - Country:US
Practice Address - Phone:817-294-0877
Practice Address - Fax:817-294-0894
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice