Individual
DR. DUSTIN LEE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
532 RAPTOR RD UNIT B, FRUITA, CO 81521-9505
(970) 639-1500
(970) 639-1501
Mailing address
532 RAPTOR RD UNIT B, FRUITA, CO 81521-9505
(970) 639-1500
(970) 639-1501
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10764
CO
1223G0001X
General Practice Dentistry
DEN00010764
CO
Other
Enumeration date
07/09/2012
Last updated
07/06/2023
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