Individual
JOHN E PATRICKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2343 E MASON ST, GREEN BAY, WI 54302-3764
(920) 468-8144
Mailing address
2343 E MASON ST, GREEN BAY, WI 54302-3764
(920) 468-8144
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5001185
WI
Other
Enumeration date
05/21/2008
Last updated
10/02/2008
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