Provider Demographics
NPI:1699295253
Name:DREW, ALEXANDER SAMUEL (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:SAMUEL
Last Name:DREW
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 1:55 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2225
Mailing Address - Country:US
Mailing Address - Phone:908-273-1200
Mailing Address - Fax:908-273-9522
Practice Address - Street 1:55 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2225
Practice Address - Country:US
Practice Address - Phone:908-273-1200
Practice Address - Fax:908-273-9522
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025797001223P0700X
NY0591021223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty