Provider Demographics
NPI:1518123306
Name:OWEN, PATRICK ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ANDREW
Last Name:OWEN
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 1:7 PITNEY ST
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840
Mailing Address - Country:US
Mailing Address - Phone:570-888-2494
Mailing Address - Fax:570-888-2067
Practice Address - Street 1:7 PITNEY ST
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840
Practice Address - Country:US
Practice Address - Phone:570-888-2494
Practice Address - Fax:570-888-2067
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036234122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist