Provider Demographics
NPI:1386707016
Name:GADOLA, PATRICK LAURENCE (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LAURENCE
Last Name:GADOLA
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 1:2015 WALMAR DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-5103
Mailing Address - Country:US
Mailing Address - Phone:517-321-8186
Mailing Address - Fax:517-321-8186
Practice Address - Street 1:204 S BOSTWICK ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1801
Practice Address - Country:US
Practice Address - Phone:517-543-2820
Practice Address - Fax:517-543-0297
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901015601122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist