Provider Demographics
NPI:1124357173
Name:PATTERSON, BRIAN S (DDS, BS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DDS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GARRETT DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:TN
Mailing Address - Zip Code:38355
Mailing Address - Country:US
Mailing Address - Phone:731-783-1111
Mailing Address - Fax:731-783-1112
Practice Address - Street 1:23 GARRETT DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:TN
Practice Address - Zip Code:38355
Practice Address - Country:US
Practice Address - Phone:731-783-1111
Practice Address - Fax:731-783-1112
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist