Provider Demographics
NPI:1528251402
Name:PATTERSON, JOHN (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:PATTERSON
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 1:3245 W RAY RD STE 6
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2438
Mailing Address - Country:US
Mailing Address - Phone:480-280-6170
Mailing Address - Fax:
Practice Address - Street 1:3245 W RAY RD STE 6
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2438
Practice Address - Country:US
Practice Address - Phone:480-280-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist