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NPI Code Detail

MEDICARE: DR. TOBIN NORMAN DRAKE D.D.S

MEDICARE:  DR. TOBIN NORMAN DRAKE  D.D.S
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
11223E0200XEndodontics08496IA

General Provider Information

NPI Number : 1134317845
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TOBIN NORMAN DRAKE D.D.S
Provider Business Mailing Address
First Line : 9202 W DODGE RD STE 301
Second Line :
City : OMAHA
State : NE
Zip : 68114-3318
Country : US
Telephone Number : 402-397-3636
Fax Number :
Provider Business Practice Location Address
First Line : 9202 W DODGE RD STE 301
Second Line :
City : OMAHA
State : NE
Zip : 68114-3318
Country : US
Telephone Number : 402-397-3636
Fax Number : 402-397-1055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2007
Last Update Date : 10/04/2023

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Directions to “ DR. TOBIN NORMAN DRAKE D.D.S” Practice Location

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