Healthcare Provider Details

I. General information

NPI: 1023537883
Provider Name (Legal Business Name): DRAIS AND CHOW DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 UPPER RAGSDALE SUITE 160
MONTEREY CA
93940
US

IV. Provider business mailing address

21 UPPER RAGSDALE SUITE 160
MONTEREY CA
93940
US

V. Phone/Fax

Practice location:
  • Phone: 831-655-2222
  • Fax:
Mailing address:
  • Phone: 831-655-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number56394
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number60808
License Number StateCA

VIII. Authorized Official

Name: DR. JOSHUA EDWARD DRAIS
Title or Position: DENTIST, CORPORATION PRESIDENT
Credential: D.D.S.
Phone: 831-655-2222