Provider Demographics
NPI:1487853206
Name:MOKRIS, PATRICK J (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:MOKRIS
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 1:1111 PERSON ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4146
Mailing Address - Country:US
Mailing Address - Phone:407-870-7404
Mailing Address - Fax:407-870-9960
Practice Address - Street 1:1111 PERSON ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4146
Practice Address - Country:US
Practice Address - Phone:407-870-7404
Practice Address - Fax:407-870-9960
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN180601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice