Provider Demographics
NPI:1912041682
Name:GOROSKI, PATRICK JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOHN
Last Name:GOROSKI
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 1:1036 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2559
Mailing Address - Country:US
Mailing Address - Phone:805-238-9581
Mailing Address - Fax:805-238-5655
Practice Address - Street 1:1036 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2559
Practice Address - Country:US
Practice Address - Phone:805-238-9581
Practice Address - Fax:805-238-5655
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics