Provider Demographics
NPI:1154545630
Name:DROBOCKY, OLES B (DMD MS)
Entity type:Individual
Prefix:DR
First Name:OLES
Middle Name:B
Last Name:DROBOCKY
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 US 31 W BY PASS
Mailing Address - Street 2:SUITE 113
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101
Mailing Address - Country:US
Mailing Address - Phone:270-843-8556
Mailing Address - Fax:270-843-8109
Practice Address - Street 1:727 US 31 W BY PASS
Practice Address - Street 2:SUITE 113
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101
Practice Address - Country:US
Practice Address - Phone:270-843-8556
Practice Address - Fax:270-843-8109
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5464122300000X
KY4531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AD1715842OtherDRUG ENFORMEMENT ADMINIST