Provider Demographics
NPI:1336104066
Name:DRUMMER, DINO LE VELLE (DDS)
Entity Type:Individual
Prefix:
First Name:DINO
Middle Name:LE VELLE
Last Name:DRUMMER
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 1:1995 W GOLDEN ROSE PL
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-7285
Mailing Address - Country:US
Mailing Address - Phone:520-742-7642
Mailing Address - Fax:520-742-7642
Practice Address - Street 1:3405 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1806
Practice Address - Country:US
Practice Address - Phone:520-888-2970
Practice Address - Fax:520-888-5125
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice