Patrick, Gary W.
Patrick, Gary W. is an sole proprietor health care provider with primary practice located at 9059 W Lake Pleasant Pkwy Suite D400, Peoria AZ 85382-8336. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Patrick, Gary W. can be contacted via phone (623) 572-0303.Contact Information
Primary practice address
9059 W Lake Pleasant Pkwy Suite D400
Peoria AZ 85382-8336
Phone: (623) 572-0303
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3980 | Arizona |
Profile Details
| NPI number | 1144363813 |
|---|---|
| LBN Legal business name | Patrick, Gary W. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144363813 | NPPES |
| Arizona | Other | 1744690 | UNITED CONCORDIA TRICARE |
| Arizona | Other | AZ0105011 | UNITED CONCORDIA TRICARE |
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