Provider Demographics
NPI:1952672925
Name:EGGE, PATRICIA ANN (RDH)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:EGGE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SW CENTURY DR
Mailing Address - Street 2:#102
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1657
Mailing Address - Country:US
Mailing Address - Phone:541-382-7708
Mailing Address - Fax:
Practice Address - Street 1:155 SW CENTURY DR
Practice Address - Street 2:#102
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1657
Practice Address - Country:US
Practice Address - Phone:541-382-7708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4769124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist