Provider Demographics
NPI:1891815478
Name:SORIA, PATRICK JOHN (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:SORIA
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 1:7585 FREDLE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9406
Mailing Address - Country:US
Mailing Address - Phone:440-354-0705
Mailing Address - Fax:440-354-0742
Practice Address - Street 1:7585 FREDLE DR
Practice Address - Street 2:SUITE A
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-9406
Practice Address - Country:US
Practice Address - Phone:440-354-0705
Practice Address - Fax:440-354-0742
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH196941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice