Provider Demographics
NPI:1699367706
Name:MICHAEL DRONE DENTISTRY AND PROSTHODONTICS
Entity type:Organization
Organization Name:MICHAEL DRONE DENTISTRY AND PROSTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DRONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:219-923-2222
Mailing Address - Street 1:9000 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2204
Mailing Address - Country:US
Mailing Address - Phone:219-923-2222
Mailing Address - Fax:219-923-2235
Practice Address - Street 1:9000 CLINE AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2204
Practice Address - Country:US
Practice Address - Phone:219-923-2222
Practice Address - Fax:219-923-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty