Provider Demographics
NPI:1861499923
Name:SABIN, PATRICK H (DMD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:H
Last Name:SABIN
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 1:628 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97630-1506
Mailing Address - Country:US
Mailing Address - Phone:541-947-5505
Mailing Address - Fax:
Practice Address - Street 1:628 N 1ST ST
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:OR
Practice Address - Zip Code:97630-1506
Practice Address - Country:US
Practice Address - Phone:541-947-5505
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR55511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice