Provider Demographics
NPI:1225702152
Name:ZAWADSKI, PATRICK D (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:D
Last Name:ZAWADSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5476 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1312
Mailing Address - Country:US
Mailing Address - Phone:651-283-7379
Mailing Address - Fax:
Practice Address - Street 1:4700 LEXINGTON AVE N
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-5867
Practice Address - Country:US
Practice Address - Phone:651-283-7379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14581122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist