Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS029037L | PA |
NPI | 1023136025 |
---|---|
Provider Name | Dr. Patrick Andrew Demarco |
First Address | Erie, PA 16501-1814 |
Second Address | Erie, PA 16501-1814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |