Provider Demographics
NPI:1629070537
Name:MCCLURE, PATRICK J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:MCCLURE
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 1:9669 HURON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-5644
Mailing Address - Country:US
Mailing Address - Phone:303-428-1155
Mailing Address - Fax:
Practice Address - Street 1:9669 HURON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-5644
Practice Address - Country:US
Practice Address - Phone:303-428-1155
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1049421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice