Provider Demographics
NPI:1649500539
Name:FRONTIER FAMILY DENTAL INC
Entity type:Organization
Organization Name:FRONTIER FAMILY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-727-6006
Mailing Address - Street 1:1840 E CALVADA BLVD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5866
Mailing Address - Country:US
Mailing Address - Phone:775-727-6006
Mailing Address - Fax:775-727-6001
Practice Address - Street 1:1840 E CALVADA BLVD
Practice Address - Street 2:SUITE 14
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5866
Practice Address - Country:US
Practice Address - Phone:775-727-6006
Practice Address - Fax:775-727-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental