Provider Demographics
NPI:1982655783
Name:DOBASH, PATRICK LAWRENCE (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:LAWRENCE
Last Name:DOBASH
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 1:13943 N 91ST AVE
Mailing Address - Street 2:STE H 102
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3689
Mailing Address - Country:US
Mailing Address - Phone:623-974-0500
Mailing Address - Fax:623-974-2212
Practice Address - Street 1:13943 N 91ST AVE
Practice Address - Street 2:STE H 102
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3689
Practice Address - Country:US
Practice Address - Phone:623-974-0500
Practice Address - Fax:623-974-2212
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4131122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist