Provider Demographics
NPI:1548332034
Name:ADOLF, VANESSA MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:MARIE
Last Name:ADOLF
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 1:397 WEST RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468
Mailing Address - Country:US
Mailing Address - Phone:610-409-2644
Mailing Address - Fax:610-409-2655
Practice Address - Street 1:397 WEST RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468
Practice Address - Country:US
Practice Address - Phone:610-409-2644
Practice Address - Fax:610-409-2655
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05030115L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice