Provider Demographics
NPI:1568885531
Name:CHRISTOPHER S. PATTON, D.D.S., P.A.
Entity Type:Organization
Organization Name:CHRISTOPHER S. PATTON, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-543-5123
Mailing Address - Street 1:730 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-1916
Mailing Address - Country:US
Mailing Address - Phone:785-543-5123
Mailing Address - Fax:785-543-2803
Practice Address - Street 1:730 4TH ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-1916
Practice Address - Country:US
Practice Address - Phone:785-543-5123
Practice Address - Fax:785-543-2803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS68511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100225640BMedicaid