Provider Demographics
NPI:1265652226
Name:MORATH, PATRICK ROBERT SR (DDS)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:ROBERT
Last Name:MORATH
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 MCCLELLAN ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403
Mailing Address - Country:US
Mailing Address - Phone:715-845-5597
Mailing Address - Fax:715-845-5597
Practice Address - Street 1:210 MCCLELLAN ST
Practice Address - Street 2:SUITE 310
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403
Practice Address - Country:US
Practice Address - Phone:715-845-5597
Practice Address - Fax:715-845-5597
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1796G122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist