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NPI Code Detail

MEDICARE: LISA PATRICK DDS

MEDICARE: LISA PATRICK DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist13167MD

General Provider Information

NPI Number : 1528258969
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA PATRICK DDS
Provider Business Mailing Address
First Line : 601 E NAYLOR MILL RD
Second Line : STE. E
City : SALISBURY
State : MD
Zip : 21804-2256
Country : US
Telephone Number : 410-219-5858
Fax Number :
Provider Business Practice Location Address
First Line : 601 E NAYLOR MILL RD
Second Line : STE. E
City : SALISBURY
State : MD
Zip : 21804-2256
Country : US
Telephone Number : 410-219-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2007
Last Update Date : 08/01/2007

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Directions to “ LISA PATRICK DDS” Practice Location

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