Provider Demographics
NPI:1568015881
Name:PATTERSON, GARETT SAMARIE
Entity Type:Individual
Prefix:DR
First Name:GARETT
Middle Name:SAMARIE
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28899 CENTER RIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8200
Mailing Address - Country:US
Mailing Address - Phone:440-835-3109
Mailing Address - Fax:
Practice Address - Street 1:5350 TRANSPORTATION BLVD STE 8
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-5307
Practice Address - Country:US
Practice Address - Phone:216-662-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0259111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice