Provider Demographics
NPI:1649266917
Name:PATTERSON, NATHAN ELLIOT (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ELLIOT
Last Name:PATTERSON
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 1:788 W CONNEXION WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-1037
Mailing Address - Country:US
Mailing Address - Phone:260-248-4858
Mailing Address - Fax:260-248-4859
Practice Address - Street 1:788 W CONNEXION WAY
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1037
Practice Address - Country:US
Practice Address - Phone:260-248-4858
Practice Address - Fax:260-248-4859
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010560A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice