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General NPI Number Information
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NPI Number | 1336388297
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Entity Type | Individual
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Provider Name | DAVID LANGDON VARBLE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 801 W COUNTY RD
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City | JERSEYVILLE
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State | IL
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Zip | 62052-2579
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Country | US
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Telephone | 618-498-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 801 W COUNTY RD
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City | JERSEYVILLE
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State | IL
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Zip | 62052-2579
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Country | US
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Telephone | 618-498-2232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.015340
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021.000947
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License Number State | IL
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