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Individual

PATRICK J LORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5801 RESEARCH PARK BLVD, STE 110, MADISON, WI 53719-6002
(608) 274-0770
(608) 274-9224
Mailing address
7821 SUMMERFIELD DR, VERONA, WI 53593-8665

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4597
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10771
DEAN HEALTH PLAN PROV#
WI
05
33720300
WI
Enumeration date
06/27/2006
Last updated
07/09/2007
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