Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 32826 | CA |
NPI | 1063764843 |
---|---|
Provider Name | Dr. J. Patrick Dunbar |
First Address | Folsom, CA 95630 |
Second Address | Folsom, CA 95630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2012 |
Last Update Date | 04/10/2012 |