Healthcare Provider Details

I. General information

NPI: 1427028943
Provider Name (Legal Business Name): PATRICK EDWARD MCGROARTY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL SIGONELLA, ITALY PSC 836
FPO AE
09636
US

IV. Provider business mailing address

PSC 836 BOX 57
FPO AE
09636-0057
US

V. Phone/Fax

Practice location:
  • Phone: 01139095564111
  • Fax:
Mailing address:
  • Phone: 01139095564111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401007698
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: