Provider Demographics
NPI:1427222611
Name:RICHARD A. PATTERSON, DDS
Entity Type:Organization
Organization Name:RICHARD A. PATTERSON, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:D D S
Authorized Official - Phone:919-781-3862
Mailing Address - Street 1:2801 BLUE RIDGE RD STE G10
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6474
Mailing Address - Country:US
Mailing Address - Phone:919-781-3862
Mailing Address - Fax:919-781-7988
Practice Address - Street 1:2801 BLUE RIDGE RD STE G10
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6474
Practice Address - Country:US
Practice Address - Phone:919-781-3862
Practice Address - Fax:919-781-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty