Provider Demographics
NPI:1215509633
Name:DRORI, ELDAD MEIR (DMD)
Entity type:Individual
Prefix:DR
First Name:ELDAD
Middle Name:MEIR
Last Name:DRORI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2730
Mailing Address - Country:US
Mailing Address - Phone:619-312-7488
Mailing Address - Fax:
Practice Address - Street 1:147 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2827
Practice Address - Country:US
Practice Address - Phone:610-664-2329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist