Provider Demographics
NPI:1285904425
Name:PATTISON, W THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:W
Middle Name:THOMAS
Last Name:PATTISON
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 1:5202 SCHUBERT RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-3834
Mailing Address - Country:US
Mailing Address - Phone:865-687-1500
Mailing Address - Fax:865-689-6247
Practice Address - Street 1:5202 SCHUBERT RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3834
Practice Address - Country:US
Practice Address - Phone:865-687-1500
Practice Address - Fax:865-689-6247
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS29001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics