Provider Demographics
NPI:1851427371
Name:DUKES, PATRICK JASON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JASON
Last Name:DUKES
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 1:854 GARTH BROOKS BLVD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3806
Mailing Address - Country:US
Mailing Address - Phone:405-354-5876
Mailing Address - Fax:
Practice Address - Street 1:854 GARTH BROOKS BLVD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-3806
Practice Address - Country:US
Practice Address - Phone:405-354-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice