Provider Demographics
NPI:1497842660
Name:PATTERSON, ANDREW S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:PATTERSON
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 1:8405 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-3407
Mailing Address - Country:US
Mailing Address - Phone:414-529-5432
Mailing Address - Fax:414-529-5432
Practice Address - Street 1:8405 W FOREST HOME AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-3407
Practice Address - Country:US
Practice Address - Phone:414-529-5432
Practice Address - Fax:414-529-5432
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice