Provider Demographics
NPI:1578931119
Name:PATTEN, ANDREW REX (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:REX
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 1:1549 WINDRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-7719
Mailing Address - Country:US
Mailing Address - Phone:865-684-9630
Mailing Address - Fax:
Practice Address - Street 1:2939 ESSARY DR STE 2
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2464
Practice Address - Country:US
Practice Address - Phone:865-687-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10153122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist