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General NPI Number Information
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NPI Number | 1164546008
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Entity Type | Organization
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Legal Business Name | PATRICK L GADOLA, DDS, PC
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 204 S BOSTWICK ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1801
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Country | US
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Telephone | 517-543-2820
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Fax | 517-543-0297
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Provider Business Mailing Address
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Address Line | 204 S BOSTWICK ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1801
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Country | US
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Telephone | 517-543-2820
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Fax | 517-543-0297
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK LAURENCE GADOLA
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Credential | DDS
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Telephone | 517-321-8186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901015601
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License Number State | MI
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