Provider Demographics
NPI:1306017314
Name:PATRICK L RANKIN DDS & ASSOC LLC
Entity Type:Organization
Organization Name:PATRICK L RANKIN DDS & ASSOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-862-4516
Mailing Address - Street 1:1317 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:OH
Mailing Address - Zip Code:43105-1044
Mailing Address - Country:US
Mailing Address - Phone:740-862-4516
Mailing Address - Fax:
Practice Address - Street 1:1317 W MARKET ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:OH
Practice Address - Zip Code:43105-1044
Practice Address - Country:US
Practice Address - Phone:740-862-4516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0136123Medicaid