Provider Demographics
NPI:1306385091
Name:BERNARDI, PATRICK ALAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ALAN
Last Name:BERNARDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E CHOCCOLOCCO ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-1223
Mailing Address - Country:US
Mailing Address - Phone:256-835-5355
Mailing Address - Fax:256-835-3990
Practice Address - Street 1:227 E CHOCCOLOCCO ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-1223
Practice Address - Country:US
Practice Address - Phone:256-835-5355
Practice Address - Fax:256-835-3990
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics