Provider Demographics
NPI:1669780946
Name:TODD E. PATTON DDS, LLC
Entity type:Organization
Organization Name:TODD E. PATTON DDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-295-1000
Mailing Address - Street 1:104 FORBES ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1516
Mailing Address - Country:US
Mailing Address - Phone:410-295-1000
Mailing Address - Fax:410-295-1001
Practice Address - Street 1:104 FORBES ST
Practice Address - Street 2:SUITE 204
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1516
Practice Address - Country:US
Practice Address - Phone:410-295-1000
Practice Address - Fax:410-295-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental