Provider Demographics
NPI:1427383983
Name:PATERSON, BRIAN CHRISTOPHER (DMD, MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:PATERSON
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-4104
Mailing Address - Country:US
Mailing Address - Phone:732-566-7648
Mailing Address - Fax:
Practice Address - Street 1:158 MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-4104
Practice Address - Country:US
Practice Address - Phone:732-566-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0381621223S0112X
NJ22DI025976001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery