Provider Demographics
NPI:1740351832
Name:DREW, DAVID S (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
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 1:9 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12789
Mailing Address - Country:US
Mailing Address - Phone:845-434-5443
Mailing Address - Fax:845-434-7265
Practice Address - Street 1:9 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12789
Practice Address - Country:US
Practice Address - Phone:845-434-5443
Practice Address - Fax:845-434-7265
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0467491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice