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Active NPI 1356014229 Organization (Entity Type 2)

Michael E Patch Dds Pllc

Clinic/Center - Dental • Jacksonville, FL

About Michael E Patch Dds Pllc NPI 1356014229 Summary

Michael E Patch Dds Pllc is a verified healthcare organization specializing in Clinic/Center - Dental operating in Jacksonville, FL. Located at 10609 OLD SAINT AUGUSTINE RD STE 3, this facility provides patient care and medical services under National Provider Identifier (NPI) 1356014229.

Administrative operations and authorized compliance are overseen by Michael Patch (Owner).

The facility is associated with 2 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

10609 Old Saint Augustine Rd Ste 3

Jacksonville, FL 322571019

Telephone 9042681331

Authorized Official Information

Authorized Contact Name

Michael Patch , DDS

Title / Role

Owner

Official Telephone

9042681331

Facility Classifications & Specialties

Clinic/Center - Dental Primary Taxonomy

NUCC Taxonomy Code: 261QD0000X

Definition to come...

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

2 Linked

Dentist - General Practice

Jacksonville, FL

View Practitioner Profile →
Dr. Gene Patch , DMD NPI 1376561639

Dentist - General Practice

Jacksonville, FL

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active July 27, 2021

NPI status registered as active in NPPES database

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Updated Practice Location July 27, 2021

Registered at 10609 OLD SAINT AUGUSTINE RD STE 3, JACKSONVILLE, FL 322571019 (Tel: 9042681331)

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Updated Business Mailing Address July 27, 2021

Registered at 10609 OLD SAINT AUGUSTINE RD STE 3, JACKSONVILLE, FL 322571019 (Tel: 9042681331)

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Organization / Clinic Name Updated July 27, 2021

Operating as MICHAEL E PATCH DDS PLLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 27, 2021

Clinic/Center

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Initial NPI Registration & Enumeration July 27, 2021

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1356014229
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 27, 2021
Last Update: July 27, 2021

Mailing Address

10609 Old Saint Augustine Rd Ste 3

Jacksonville, FL 322571019

Phone: 9042681331

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.