Provider Demographics
NPI:1346768538
Name:PATTERSON, PAIGE L (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:L
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:L
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 TRILITH PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4615
Mailing Address - Country:US
Mailing Address - Phone:678-799-9810
Mailing Address - Fax:
Practice Address - Street 1:210 TRILITH PKWY STE 120
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4615
Practice Address - Country:US
Practice Address - Phone:678-799-9810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1230551223G0001X
NC108341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice