Provider Demographics
NPI:1407964059
Name:MARC PATRICK ENTERPRISES PC
Entity Type:Organization
Organization Name:MARC PATRICK ENTERPRISES PC
Other - Org Name:ALL SMILES DENTAL - MARC B PATRICK DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-286-4444
Mailing Address - Street 1:1210 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-9998
Mailing Address - Country:US
Mailing Address - Phone:580-286-4444
Mailing Address - Fax:580-286-7632
Practice Address - Street 1:1210 E WASHINGTON
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-9998
Practice Address - Country:US
Practice Address - Phone:580-286-4444
Practice Address - Fax:580-286-7632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty