Provider Demographics
NPI:1760528368
Name:GOCHAR, PATRICK W (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:W
Last Name:GOCHAR
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 1:6100 DAYLONG LN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1626
Mailing Address - Country:US
Mailing Address - Phone:410-531-9400
Mailing Address - Fax:
Practice Address - Street 1:6100 DAYLONG LN
Practice Address - Street 2:SUITE 204
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1626
Practice Address - Country:US
Practice Address - Phone:410-531-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD117281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice