Provider Demographics
NPI:1063743458
Name:NOLAN, PATRICK J (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:NOLAN
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3332 ROCHAMBEAU AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2836
Mailing Address - Country:US
Mailing Address - Phone:718-920-5993
Mailing Address - Fax:718-515-5419
Practice Address - Street 1:3332 ROCHAMBEAU AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2836
Practice Address - Country:US
Practice Address - Phone:718-920-5993
Practice Address - Fax:718-515-5419
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2019-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYP651661223S0112X
NY0562221204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery