Provider Demographics
NPI:1982233961
Name:CONNER, DRAKE WESTON (DDS)
Entity Type:Individual
Prefix:
First Name:DRAKE
Middle Name:WESTON
Last Name:CONNER
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 1:660 RALPH MCGILL BLVD NE APT 4304
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1163
Mailing Address - Country:US
Mailing Address - Phone:636-575-4919
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD
Practice Address - Street 2:NE, BUILDING B, SUITE 2300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program