Provider Demographics
NPI:1922327881
Name:MADDEN, PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:MADDEN
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 1:573 COUNTY ROUTE 16
Mailing Address - Street 2:PO BOX 180
Mailing Address - City:MEXICO
Mailing Address - State:NY
Mailing Address - Zip Code:13114-3412
Mailing Address - Country:US
Mailing Address - Phone:315-402-7059
Mailing Address - Fax:
Practice Address - Street 1:3358 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:NY
Practice Address - Zip Code:13114-3002
Practice Address - Country:US
Practice Address - Phone:315-963-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055686122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist