Provider Demographics
NPI:1497249031
Name:PATTEN, THOMAS P (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:PATTEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CLARENDON
Mailing Address - State:AR
Mailing Address - Zip Code:72029-2706
Mailing Address - Country:US
Mailing Address - Phone:870-747-3381
Mailing Address - Fax:870-747-3631
Practice Address - Street 1:245 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARENDON
Practice Address - State:AR
Practice Address - Zip Code:72029-2706
Practice Address - Country:US
Practice Address - Phone:870-747-3381
Practice Address - Fax:870-747-3631
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR42741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice