Provider Demographics
NPI:1720229438
Name:DAULTON, PATRICK E (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:E
Last Name:DAULTON
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 1:1400 ELMORE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2722
Mailing Address - Country:US
Mailing Address - Phone:614-262-1237
Mailing Address - Fax:
Practice Address - Street 1:1400 ELMORE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2722
Practice Address - Country:US
Practice Address - Phone:614-262-1237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.015417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist