Provider Demographics
NPI:1215667852
Name:PATTERSON, BENJAMIN JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JAMES
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 1:3735 RHODE ISLAND AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4344
Mailing Address - Country:US
Mailing Address - Phone:507-226-1474
Mailing Address - Fax:
Practice Address - Street 1:1895 PLAZA DR STE 130
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4601
Practice Address - Country:US
Practice Address - Phone:651-454-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14768122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist