Individual
PATRICK MINNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 JACKSON BLVD, COLUMBIA, SC 29207-7015
(803) 782-9802
Mailing address
239 BEACONS FIELD RD, COLUMBIA, SC 29209-5096
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS-09775
IA
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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