Provider Demographics
NPI:1023031721
Name:PATE, RAYMOND GERALD (DMD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:GERALD
Last Name:PATE
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 1:2315 CATAWBA VALLEY BLVD SE STE 5
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4163
Mailing Address - Country:US
Mailing Address - Phone:828-327-7283
Mailing Address - Fax:828-327-3331
Practice Address - Street 1:2315 CATAWBA VALLEY BLVD SE STE 5
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4163
Practice Address - Country:US
Practice Address - Phone:828-327-7283
Practice Address - Fax:828-327-3331
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice