Individual
DR. GARY W. PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
9059 W LAKE PLEASANT PKWY, SUITE D400, PEORIA, AZ 85382-8336
(623) 572-0303
Mailing address
9059 W LAKE PLEASANT PKWY, SUITE D400, PEORIA, AZ 85382-8336
(623) 572-0303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3980
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1744690
UNITED CONCORDIA TRICARE
AZ
01
—
AZ0105011
BCBS OF AZ
AZ
Enumeration date
02/14/2007
Last updated
07/08/2007
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