Provider Demographics
NPI:1972969194
Name:JOHN PATTERSON DMD PLC
Entity Type:Organization
Organization Name:JOHN PATTERSON DMD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-280-6170
Mailing Address - Street 1:3245 W RAY RD
Mailing Address - Street 2:#6
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2438
Mailing Address - Country:US
Mailing Address - Phone:480-280-6170
Mailing Address - Fax:
Practice Address - Street 1:3245 W RAY RD
Practice Address - Street 2:#6
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2438
Practice Address - Country:US
Practice Address - Phone:480-280-6170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Single Specialty