Provider Demographics
NPI:1013934686
Name:DROSKE, TERRY W (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:W
Last Name:DROSKE
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 1:4617 SUMMERHILL RD
Mailing Address - Street 2:#3
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2784
Mailing Address - Country:US
Mailing Address - Phone:903-792-5500
Mailing Address - Fax:903-792-5185
Practice Address - Street 1:4617 SUMMERHILL RD
Practice Address - Street 2:#3
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2784
Practice Address - Country:US
Practice Address - Phone:903-792-5500
Practice Address - Fax:903-792-5185
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice