Provider Demographics
NPI:1235581778
Name:DREWYER, AUSTIN DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:DAVID
Last Name:DREWYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 SANDY SPRING RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1122
Mailing Address - Country:US
Mailing Address - Phone:301-622-1717
Mailing Address - Fax:
Practice Address - Street 1:4009 SANDY SPRING RD STE 201
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1122
Practice Address - Country:US
Practice Address - Phone:301-622-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD160261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice