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Individual

KYLE D. PATCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1200 NETWORK CENTRE DR STE 2, EFFINGHAM, IL 62401-4637
(217) 540-5100
Mailing address
1200 NETWORK CENTRE DR STE 2, EFFINGHAM, IL 62401-4637
(217) 540-8386

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001919-15
WI

Other

Enumeration date
08/21/2018
Last updated
08/21/2018
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