Provider Demographics
NPI:1619023991
Name:PATTERSON, EUGENE M (DMD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ROBERTS BLVD
Mailing Address - Street 2:PO BOX 567
Mailing Address - City:WILLIAMSTON
Mailing Address - State:SC
Mailing Address - Zip Code:29697-1136
Mailing Address - Country:US
Mailing Address - Phone:864-847-9511
Mailing Address - Fax:
Practice Address - Street 1:12 ROBERTS BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:SC
Practice Address - Zip Code:29697-1136
Practice Address - Country:US
Practice Address - Phone:864-847-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice