Provider Demographics
NPI:1952426603
Name:AINSLIE, PATRICK T (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:T
Last Name:AINSLIE
Suffix:
Gender:M
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3910
Mailing Address - Country:US
Mailing Address - Phone:248-540-0120
Mailing Address - Fax:248-540-0108
Practice Address - Street 1:50 W BIG BEAVER RD
Practice Address - Street 2:SUITE 150
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-3910
Practice Address - Country:US
Practice Address - Phone:248-540-0120
Practice Address - Fax:248-540-0108
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPA109941223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics