Provider Demographics
NPI:1598117046
Name:PATTON, MEREDITH (DDS)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 FERN AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5732
Mailing Address - Country:US
Mailing Address - Phone:318-797-1181
Mailing Address - Fax:318-797-1180
Practice Address - Street 1:7607 FERN AVE STE 800
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5732
Practice Address - Country:US
Practice Address - Phone:318-797-1181
Practice Address - Fax:318-797-1180
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6691122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist