Provider Demographics
NPI:1528391158
Name:MCGUNNIGLE, PATRICK E (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:E
Last Name:MCGUNNIGLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PATRICK
Other - Middle Name:E
Other - Last Name:MCGUNNIGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:260 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2922
Mailing Address - Country:US
Mailing Address - Phone:516-931-0400
Mailing Address - Fax:516-931-1701
Practice Address - Street 1:260 N BROADWAY
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2922
Practice Address - Country:US
Practice Address - Phone:516-931-0400
Practice Address - Fax:516-931-1701
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0313371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice