Provider Demographics
NPI:1124913926
Name:CARLISLE, PATRICK EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:EDWARD
Last Name:CARLISLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 BAYLEAF CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1247
Mailing Address - Country:US
Mailing Address - Phone:256-612-1000
Mailing Address - Fax:
Practice Address - Street 1:2321 BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-5422
Practice Address - Country:US
Practice Address - Phone:743-910-0958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14191122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist