Healthcare Provider Details

I. General information

NPI: 1912111949
Provider Name (Legal Business Name): JAMIE RAE DROWLEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11519 VELICATA CT
LAS VEGAS NV
89138-7581
US

IV. Provider business mailing address

11519 VELICATA CT
LAS VEGAS NV
89138-7581
US

V. Phone/Fax

Practice location:
  • Phone: 702-228-3459
  • Fax: 702-228-3459
Mailing address:
  • Phone: 702-228-3459
  • Fax: 702-228-3459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4593T
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: