Provider Demographics
NPI:1306958871
Name:MITCHELL, C PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:C
Middle Name:PATRICK
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5665 TRANS MOUNTAIN RD
Mailing Address - Street 2:STE 201
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-4100
Mailing Address - Country:US
Mailing Address - Phone:915-751-7779
Mailing Address - Fax:915-755-2265
Practice Address - Street 1:5665 TRANS MOUNTAIN RD
Practice Address - Street 2:STE 201
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4100
Practice Address - Country:US
Practice Address - Phone:915-751-7779
Practice Address - Fax:915-755-2265
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX16444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist