Provider Demographics
NPI:1720113764
Name:DRYDEN, DAVID WILLIAM (RPH, ESQ)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WILLIAM
Last Name:DRYDEN
Suffix:
Gender:M
Credentials:RPH, ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 SILVER LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2467
Mailing Address - Country:US
Mailing Address - Phone:302-744-4527
Mailing Address - Fax:302-739-2711
Practice Address - Street 1:861 SILVER LAKE BLVD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2467
Practice Address - Country:US
Practice Address - Phone:302-744-4527
Practice Address - Fax:302-739-2711
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist