Provider Demographics
NPI:1669764346
Name:WALKER, PATRICK E (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:E
Last Name:WALKER
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 1:827 BLOSSOM HILL RD STE W8
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2701
Mailing Address - Country:US
Mailing Address - Phone:408-578-0240
Mailing Address - Fax:408-578-0750
Practice Address - Street 1:827 BLOSSOM HILL RD STE W8
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-2701
Practice Address - Country:US
Practice Address - Phone:408-578-0240
Practice Address - Fax:408-578-0750
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA256461223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics