Provider Demographics
NPI:1952513400
Name:DRABIN, MICHAEL DENNIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:DRABIN
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 1:325 ALBANY TPKE
Mailing Address - Street 2:P.O. BOX 431
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2528
Mailing Address - Country:US
Mailing Address - Phone:860-693-0011
Mailing Address - Fax:
Practice Address - Street 1:325 ALBANY TPKE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2528
Practice Address - Country:US
Practice Address - Phone:860-693-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT44861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice