Provider Demographics
NPI:1013279462
Name:PATTI, CHRISTIAN ROSARIO (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ROSARIO
Last Name:PATTI
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 1:5509 PAULSEN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4902
Mailing Address - Country:US
Mailing Address - Phone:912-354-9204
Mailing Address - Fax:912-420-5020
Practice Address - Street 1:5509 PAULSEN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4902
Practice Address - Country:US
Practice Address - Phone:912-354-9204
Practice Address - Fax:912-420-5020
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC70981223G0001X
MADN213931223G0001X
GADN0144011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice