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General NPI Number Information
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NPI Number | 1952029928
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Entity Type | Organization
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Legal Business Name | DREW DENTAL CORP
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 783 RIO DEL MAR BLVD
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City | APTOS
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State | CA
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Zip | 95003-4771
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Country | US
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Telephone | 408-688-6060
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Fax | 408-688-4312
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Provider Business Mailing Address
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Address Line | 783 RIO DEL MAR BLVD
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City | APTOS
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State | CA
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Zip | 95003-4771
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Country | US
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Telephone | 408-355-5023
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Fax | 408-688-4312
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON DREW
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Credential | DDS
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Telephone | 408-355-5023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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