Provider Demographics
NPI:1821154931
Name:DREW, ROBERT STEPHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:DREW
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 1:610 NORTHRIDGE RD
Mailing Address - Street 2:PO BOX 397
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1181
Mailing Address - Country:US
Mailing Address - Phone:740-474-6535
Mailing Address - Fax:
Practice Address - Street 1:610 NORTHRIDGE RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1181
Practice Address - Country:US
Practice Address - Phone:740-474-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300124391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice