Provider Demographics
NPI:1619074424
Name:DR PATRICK M PAIGE DDS INC
Entity Type:Organization
Organization Name:DR PATRICK M PAIGE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-948-4641
Mailing Address - Street 1:43713 20TH ST W
Mailing Address - Street 2:#5
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4628
Mailing Address - Country:US
Mailing Address - Phone:661-948-4641
Mailing Address - Fax:661-935-4221
Practice Address - Street 1:43713 20TH ST W
Practice Address - Street 2:#5
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4628
Practice Address - Country:US
Practice Address - Phone:661-948-4641
Practice Address - Fax:661-935-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty