Individual
PATRICK T VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
21701 76TH AVE W, EDMONDS, WA 98026-7536
(425) 744-1724
Mailing address
21701 76TH AVE W, EDMONDS, WA 98026-7536
(425) 744-1724
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D13879
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D13879
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
72276
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D13879
MN
Other
Enumeration date
06/25/2017
Last updated
01/19/2024
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