Provider Demographics
NPI:1710138219
Name:ASHTON CREEK ORAL SURGERY SUITES, P.L.L.C.
Entity Type:Organization
Organization Name:ASHTON CREEK ORAL SURGERY SUITES, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-495-1800
Mailing Address - Street 1:9118 S TOLEDO AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2700
Mailing Address - Country:US
Mailing Address - Phone:918-495-1800
Mailing Address - Fax:918-495-1890
Practice Address - Street 1:9118 S TOLEDO AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2700
Practice Address - Country:US
Practice Address - Phone:918-495-1800
Practice Address - Fax:918-495-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery