Provider Demographics
NPI:1316130727
Name:PATE, RAYMOND L (DMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:L
Last Name:PATE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 SHARPSBURG CIR
Mailing Address - Street 2:808 SHARPSBURG CIRCLE
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1726
Mailing Address - Country:US
Mailing Address - Phone:205-451-9006
Mailing Address - Fax:205-451-9006
Practice Address - Street 1:808 SHARPSBURG CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1726
Practice Address - Country:US
Practice Address - Phone:205-451-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist