Eastridge Dental Associates, S.c.

NPI #1184775892 in Green Bay, Wisconsin

Provider Information

NPI Number
1184775892
Entity Type
Organization
Organization Name
Eastridge Dental Associates, S.c.
Primary Specialty
Dentist
Enumeration Date
Jan 16, 2007
Last Updated
Jul 1, 2008

Practice Location

Address
2343 E MASON ST
ZIP Code
54302-3764
Phone
(920) 468-8144

Authorized Official

Name
DR. JOHN E. PATRICKUS, DDS
Title
PRESIDENT
Phone
(920) 468-8144

Specialties & Taxonomy Codes

Specialty
Dentist

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