| Jonathan M Drew DDS Inc | |
|
120 9th St Lakeport CA 95453-4320 | |
| (707) 263-5390 | |
| Not Available |
| Full Name | Jonathan M Drew DDS Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 120 9th St, Lakeport, California |
| Authorized Official Name and Position | Jonathan Michael Drew (OWNER) |
| Authorized Official Contact | 4083149870 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan M Drew DDS Inc 120 9th St Lakeport CA 95453-4320 Ph: (707) 263-5390 | Jonathan M Drew DDS Inc 120 9th St Lakeport CA 95453-4320 Ph: (707) 263-5390 |
| NPI Number | 1336830116 |
|---|---|
| Provider Enumeration Date | 05/15/2023 |
| Last Update Date | 05/15/2023 |
| Certification Date | 05/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336830116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (NU) | Primary |
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