Provider Demographics
NPI:1376548404
Name:MCCONNELL, PATRICIA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 E CALUMET ST
Mailing Address - Street 2:STE 600
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-4163
Mailing Address - Country:US
Mailing Address - Phone:920-968-5000
Mailing Address - Fax:920-968-5002
Practice Address - Street 1:3825 E CALUMET ST
Practice Address - Street 2:STE 600
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4163
Practice Address - Country:US
Practice Address - Phone:920-968-5000
Practice Address - Fax:920-968-5002
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice