Provider Demographics
NPI:1710090873
Name:PATTON, TODD EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:EDWARD
Last Name:PATTON
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 1:104 FORBES ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1516
Mailing Address - Country:US
Mailing Address - Phone:410-925-9779
Mailing Address - Fax:
Practice Address - Street 1:104 FORBES ST
Practice Address - Street 2:SUITE 204
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1516
Practice Address - Country:US
Practice Address - Phone:410-925-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice