Provider Demographics
NPI:1174622823
Name:KINGSTON, PATRICIA (D,D,S,, MS)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:D,D,S,, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 PINE CIR
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-3938
Mailing Address - Country:US
Mailing Address - Phone:612-747-7337
Mailing Address - Fax:218-736-7204
Practice Address - Street 1:1926 PINE CIR
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-3938
Practice Address - Country:US
Practice Address - Phone:612-747-7337
Practice Address - Fax:218-736-7204
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND86051223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics