Provider Demographics
NPI:1215158506
Name:DRAKE, DAVID EDWARD (DAVID DRAKE DMD,LTD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:DRAKE
Suffix:
Gender:M
Credentials:DAVID DRAKE DMD,LTD
Other - Prefix:MRS
Other - First Name:NINA
Other - Middle Name:LEA
Other - Last Name:WILE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DAVID DRAKE
Mailing Address - Street 1:759 STOUFFER AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2859
Mailing Address - Country:US
Mailing Address - Phone:717-263-0442
Mailing Address - Fax:717-263-7489
Practice Address - Street 1:759 STOUFFER AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2859
Practice Address - Country:US
Practice Address - Phone:717-263-0442
Practice Address - Fax:717-263-7489
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD5018277L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics