Organization
DR.THOMAS E. DRAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA PRICE (FRONT OFFICE)
(985) 792-0515
Entity
Organization
Contact information
Practice address
1519 HIGHWAY 22 W, SUITE #3, MADISONVILLE, LA 70447-9489
(985) 792-0515
(985) 792-0517
Mailing address
1519 HIGHWAY 22 W, SUITE #3, MADISONVILLE, LA 70447-9489
(985) 792-0515
(985) 792-0517
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2638
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1880132
—
LA
Enumeration date
05/19/2008
Last updated
05/19/2008
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