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General NPI Number Information
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NPI Number | 1295714996
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Entity Type | Individual
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Provider Name | ORBITO IGNACIO PATANGAN JR. D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 04/06/2020
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Provider Practice Location Address
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Address Line | 2700 BROAD RIVER RD
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City | COLUMBIA
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State | SC
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Zip | 29210-6055
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Country | US
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Telephone | 803-621-0902
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Fax |
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Provider Business Mailing Address
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Address Line | 903 SEABROOK CT
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City | LEXINGTON
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State | SC
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Zip | 29072-7462
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Country | US
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Telephone | 619-592-9247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19727
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 12011756A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 19727
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 948
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License Number State | SC
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