Provider Demographics
NPI:1821229675
Name:VARBLE, PATRICK RAY (DMD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:RAY
Last Name:VARBLE
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 1:801 W COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2579
Mailing Address - Country:US
Mailing Address - Phone:618-498-2232
Mailing Address - Fax:618-498-4738
Practice Address - Street 1:801 W COUNTY RD
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2579
Practice Address - Country:US
Practice Address - Phone:618-498-2232
Practice Address - Fax:618-498-4738
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021-001893174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist