Provider Demographics
NPI:1346254190
Name:MACRAE, PATRICK CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CHARLES
Last Name:MACRAE
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 1:829 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-2578
Mailing Address - Country:US
Mailing Address - Phone:864-878-3501
Mailing Address - Fax:864-878-3502
Practice Address - Street 1:829 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2578
Practice Address - Country:US
Practice Address - Phone:864-878-3501
Practice Address - Fax:864-878-3502
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice