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NPI Code Detail

MEDICARE: GOROSKI DENTAL CORPORATION

MEDICARE: GOROSKI DENTAL CORPORATION
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
11223P0300XPeriodontics53066CA

General Provider Information

NPI Number : 1669777199
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOROSKI DENTAL CORPORATION
Provider Business Mailing Address
First Line : 1036 VINE ST
Second Line :
City : PASO ROBLES
State : CA
Zip : 93446-2559
Country : US
Telephone Number : 805-238-9581
Fax Number : 805-238-5655
Provider Business Practice Location Address
First Line : 1036 VINE ST
Second Line :
City : PASO ROBLES
State : CA
Zip : 93446-2559
Country : US
Telephone Number : 805-238-9581
Fax Number : 805-238-5655
Authorized Official
Title or Position : OWNER
Name : DR. PATRICK JOHN GOROSKI
Credential : DDS
Telephone Number : 805-238-9581
Provider Enumeration Date : 01/13/2011
Last Update Date : 04/25/2013

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Directions to “GOROSKI DENTAL CORPORATION ” Practice Location

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