Provider Demographics
NPI:1821008525
Name:JOHNS, PATRICK P (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:P
Last Name:JOHNS
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 1:1331 W BOONVILLE NEW HARMONY ROAD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-9583
Mailing Address - Country:US
Mailing Address - Phone:812-867-6428
Mailing Address - Fax:812-867-7494
Practice Address - Street 1:1331 W BOONVILLE NEW HARMONY ROAD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-9583
Practice Address - Country:US
Practice Address - Phone:812-867-6428
Practice Address - Fax:812-867-7494
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007351A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist