Provider Demographics
NPI:1376658021
Name:PATRICK M. NEARING, D.M.D., P.C.
Entity Type:Organization
Organization Name:PATRICK M. NEARING, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:NEARING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-963-8585
Mailing Address - Street 1:1614 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2516
Mailing Address - Country:US
Mailing Address - Phone:541-963-8585
Mailing Address - Fax:541-963-6633
Practice Address - Street 1:1614 5TH ST
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2516
Practice Address - Country:US
Practice Address - Phone:541-963-8585
Practice Address - Fax:541-963-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR55431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty