Organization
DRS DRAKE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE ADDISON DRAKE DDS (PRESIDENT OWNER)
(815) 547-8112
Entity
Organization
Contact information
Practice address
515 PEARL STREET, BELVIDERE, IL 61008
(815) 547-8112
(815) 544-5480
Mailing address
515 PEARL STREET, BELVIDERE, IL 61008
(815) 547-8112
(815) 544-5480
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1915991
IL
122300000X
Dentist
1917128
IL
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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