Provider Demographics
NPI:1962483420
Name:FOY, PATRICK JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOHN
Last Name:FOY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:3340 REPUBLIC AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426
Mailing Address - Country:US
Mailing Address - Phone:952-938-2740
Mailing Address - Fax:612-332-9165
Practice Address - Street 1:3340 REPUBLIC AVE
Practice Address - Street 2:STE 130
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-938-2740
Practice Address - Fax:612-332-9165
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MND90891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN077800102OtherADA
MND9089OtherSTATE DENTAL LICENSE
MN768218200Medicaid