Provider Demographics
NPI:1770886020
Name:DRAKE, EVE MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:EVE
Middle Name:MARIE
Last Name:DRAKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:MARIE
Other - Last Name:MCCANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:435 LIMEKILN DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4510
Mailing Address - Country:US
Mailing Address - Phone:717-267-3922
Mailing Address - Fax:717-267-3154
Practice Address - Street 1:435 LIMEKILN DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4510
Practice Address - Country:US
Practice Address - Phone:717-267-3922
Practice Address - Fax:717-267-3154
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist