Provider Demographics
NPI:1437292489
Name:DOWLING, PATRICK GERARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:GERARD
Last Name:DOWLING
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:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:WINNECONNE
Mailing Address - State:WI
Mailing Address - Zip Code:54986-0520
Mailing Address - Country:US
Mailing Address - Phone:920-622-3382
Mailing Address - Fax:920-582-7563
Practice Address - Street 1:902 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WINNECONNE
Practice Address - State:WI
Practice Address - Zip Code:54986-9782
Practice Address - Country:US
Practice Address - Phone:920-582-4427
Practice Address - Fax:920-582-7563
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2015G1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU93744Medicare ID - Type Unspecified