Healthcare Provider Details

I. General information

NPI: 1982508495
Provider Name (Legal Business Name): PATTERSON FAMILY SMILES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 WARWOMAN RD
CLAYTON GA
30525-5102
US

IV. Provider business mailing address

303 WARWOMAN RD
CLAYTON GA
30525-5102
US

V. Phone/Fax

Practice location:
  • Phone: 706-782-5414
  • Fax:
Mailing address:
  • Phone: 706-782-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHIP REX PATTERSON
Title or Position: OWNER
Credential: DMD
Phone: 706-782-5414