Provider Demographics
NPI:1407474547
Name:PATTERSON, MARCELA D (DMD)
Entity Type:Individual
Prefix:
First Name:MARCELA
Middle Name:D
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARCELA
Other - Middle Name:
Other - Last Name:DIDONATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5130 LINTON BLVD STE D2
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6595
Mailing Address - Country:US
Mailing Address - Phone:561-496-2222
Mailing Address - Fax:561-496-6688
Practice Address - Street 1:5130 LINTON BLVD STE D2
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6595
Practice Address - Country:US
Practice Address - Phone:561-496-2222
Practice Address - Fax:561-496-6688
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN250401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice