Provider Demographics
NPI:1073517447
Name:PATTERSON, EILEEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:E
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST
Mailing Address - Street 2:STE 1130
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1714
Mailing Address - Country:US
Mailing Address - Phone:218-722-1949
Mailing Address - Fax:218-722-1858
Practice Address - Street 1:324 W SUPERIOR ST
Practice Address - Street 2:STE 1130
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1714
Practice Address - Country:US
Practice Address - Phone:218-722-1949
Practice Address - Fax:218-722-1858
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11042122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist