Provider Demographics
NPI:1881755239
Name:MIGLIORE, PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:MIGLIORE
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 1:1202 E SONTERRA BLVD
Mailing Address - Street 2:STE 702
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4089
Mailing Address - Country:US
Mailing Address - Phone:210-340-0995
Mailing Address - Fax:210-340-1095
Practice Address - Street 1:1202 E SONTERRA BLVD
Practice Address - Street 2:STE 702
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4089
Practice Address - Country:US
Practice Address - Phone:210-340-0995
Practice Address - Fax:210-340-1095
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics