MEDICARE: DR. PAMELA JEAN PATTEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4548	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255461836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA JEAN PATTEN DDS

Provider Business Mailing Address
First Line	:	1840 E CALVADA BLVD
Second Line	:	SUITE 14
City	:	PAHRUMP
State	:	NV
Zip	:	89048-5866
Country	:	US
Telephone Number	:	775-727-6006
Fax Number	:	775-727-6001

Provider Business Practice Location Address
First Line	:	1840 E CALVADA BLVD
Second Line	:	SUITE 14
City	:	PAHRUMP
State	:	NV
Zip	:	89048-5866
Country	:	US
Telephone Number	:	775-727-6006
Fax Number	:	775-727-6001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	06/30/2008

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