Provider Demographics
NPI:1346579356
Name:PATTERSON FAMILY DENTISTRY
Entity Type:Organization
Organization Name:PATTERSON FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-233-0127
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty