Individual
DR. EMMANUEL J PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1125 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-6324
(651) 842-8426
Mailing address
15546 OMEGA TRL SE, PRIOR LAKE, MN 55372-2033
(952) 807-2248
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14296
MN
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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