Provider Demographics
NPI:1255131397
Name:DRAVECK, JAMES BARRY II (DMD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BARRY
Last Name:DRAVECK
Suffix:II
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 WESTEDGE ST APT 207
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-4979
Mailing Address - Country:US
Mailing Address - Phone:315-751-9169
Mailing Address - Fax:
Practice Address - Street 1:99 WESTEDGE ST APT 207
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-4979
Practice Address - Country:US
Practice Address - Phone:315-751-9169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program