Provider Demographics
NPI:1841372661
Name:DELAND, PATRICIA ANNE (RDH)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:DELAND
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LILIENWEG 1
Mailing Address - Street 2:
Mailing Address - City:BRUEHL
Mailing Address - State:BADEN WUERTEMBOURG
Mailing Address - Zip Code:68723
Mailing Address - Country:DE
Mailing Address - Phone:0621-857-9450
Mailing Address - Fax:
Practice Address - Street 1:CMR 442
Practice Address - Street 2:HEIDELBERG DENTAL ACTIVITY CREDENTIALS OFFICE
Practice Address - City:APO AE
Practice Address - State:NY
Practice Address - Zip Code:09042
Practice Address - Country:US
Practice Address - Phone:622-117-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH5765124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist