Provider Demographics
NPI:1235163262
Name:MCDADE, PATRICK BRUCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:BRUCE
Last Name:MCDADE
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 1:228 LOMBARD ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:805-497-8536
Mailing Address - Fax:805-497-1417
Practice Address - Street 1:228 LOMBARD ST
Practice Address - Street 2:SUITE D
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-497-8536
Practice Address - Fax:805-497-1417
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA231281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice