MEDICARE: ROBERT DRURY II DDS

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	122300000X	Dentist	58493	CA

General Provider Information

NPI Number	:	1427165398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT DRURY II DDS

Provider Business Mailing Address
First Line	:	5995 MISSION GORGE RD
Second Line	:	STE A
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-4028
Country	:	US
Telephone Number	:	760-716-7466
Fax Number	:	619-282-4394

Provider Business Practice Location Address
First Line	:	5995 MISSION GORGE RD
Second Line	:	STE A
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-4028
Country	:	US
Telephone Number	:	760-716-7466
Fax Number	:	619-282-4394

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/11/2013

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