MEDICARE: DR. DREW CHRISTOPHER ECKMAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DSO38705	PA

General Provider Information

NPI Number	:	1225300460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DREW CHRISTOPHER ECKMAN D.D.S.

Provider Business Mailing Address
First Line	:	301 N 3RD ST
Second Line	:
City	:	OXFORD
State	:	PA
Zip	:	19363-1429
Country	:	US
Telephone Number	:	610-932-8289
Fax Number	:	610-932-7757

Provider Business Practice Location Address
First Line	:	110 CHESAPEAKE RIDGE LN APT 3D
Second Line	:
City	:	NORTH EAST
State	:	MD
Zip	:	21901-2357
Country	:	US
Telephone Number	:	610-932-8289
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2012
Last Update Date	:	02/03/2012

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