Provider Demographics
NPI:1730635178
Name:NCDI DRAKE, PROFESSIONAL LLP
Entity Type:Organization
Organization Name:NCDI DRAKE, PROFESSIONAL LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-223-8687
Mailing Address - Street 1:383 W DRAKE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2884
Mailing Address - Country:US
Mailing Address - Phone:970-223-8687
Mailing Address - Fax:970-207-1971
Practice Address - Street 1:383 W DRAKE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2884
Practice Address - Country:US
Practice Address - Phone:970-223-8687
Practice Address - Fax:970-207-1971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SVC DENTAL GROUP, PROFESSIONAL LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty