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General NPI Number Information
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NPI Number | 1376658021
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Entity Type | Organization
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Legal Business Name | PATRICK M. NEARING, D.M.D., P.C.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1614 5TH ST
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City | LA GRANDE
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State | OR
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Zip | 97850-2516
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Country | US
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Telephone | 541-963-8585
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Fax | 541-963-6633
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Provider Business Mailing Address
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Address Line | 1614 5TH ST
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City | LA GRANDE
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State | OR
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Zip | 97850-2516
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Country | US
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Telephone | 541-963-8585
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Fax | 541-963-6633
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK MICHAEL NEARING
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Credential | D.M.D.
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Telephone | 541-963-8585
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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 | 5543
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License Number State | OR
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