Provider Demographics
NPI:1295896363
Name:VONDELL, GINGER (DMD)
Entity type:Individual
Prefix:DR
First Name:GINGER
Middle Name:
Last Name:VONDELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CORNWALL RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7403
Mailing Address - Country:US
Mailing Address - Phone:717-272-6571
Mailing Address - Fax:717-273-7222
Practice Address - Street 1:1500 CORNWALL RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7403
Practice Address - Country:US
Practice Address - Phone:717-272-6571
Practice Address - Fax:717-273-7222
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO26755L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice