Provider Demographics
NPI:1336388297
Name:VARBLE, DAVID LANGDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LANGDON
Last Name:VARBLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:LANGDON
Other - Last Name:VARBLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:801 W COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2579
Mailing Address - Country:US
Mailing Address - Phone:618-498-2232
Mailing Address - Fax:
Practice Address - Street 1:801 W COUNTY RD
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2579
Practice Address - Country:US
Practice Address - Phone:618-498-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.015340122300000X
IL021.0009471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist