Guy C Drake, DDS
Individual provider Active NPI Dentist · Thermopolis, WY
NPI 1144368366 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144368366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 774 (WY)
- Practice address
- 110 E Arapahoe
Thermopolis, WY 82443 - Phone
- (307) 864-9411
- Fax
- (307) 864-2756
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 774 | WY | MD | Critical Care Registered Respiratory Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paintbrush Dental, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 774 | WY | Yes |
Addresses
Primary practice location
110 E Arapahoe
Thermopolis, WY 82443
Mailing address
PO Box 751
Thermopolis, WY 82443
Phone (307) 864-9411
Other providers in Thermopolis, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.