Healthcare Provider Details

I. General information

NPI: 1376136879
Provider Name (Legal Business Name): PATRICK STEVEN DROCKTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 FOOTE RD
MEDINA OH
44256-5396
US

IV. Provider business mailing address

5002 FOOTE RD
MEDINA OH
44256-5396
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-8449
  • Fax:
Mailing address:
  • Phone: 330-725-8449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30.028355
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: