Provider Demographics
NPI:1093972663
Name:PATTERSON, DAVID REX (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:REX
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BIG A RD
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-6030
Mailing Address - Country:US
Mailing Address - Phone:706-886-7433
Mailing Address - Fax:706-886-8425
Practice Address - Street 1:1301 BIG A RD
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-6030
Practice Address - Country:US
Practice Address - Phone:706-886-7433
Practice Address - Fax:706-886-8425
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice