Dale Addison Drake, DENTIST DDS

NPI #1225200892 in Belvidere, Illinois

Provider Information

NPI Number: 1225200892
Entity Type: Individual
Name: Dale Addison Drake, DENTIST DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DENTIST DDS
Enumeration Date: Mar 24, 2008
Last Updated: Mar 24, 2008

Practice Location

Address: 515 PEARL STREET
City: Belvidere
State: Illinois
ZIP Code: 61008
Phone: (815) 547-8112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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