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General NPI Number Information
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NPI Number | 1598986044
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Entity Type | Individual
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Provider Name | DR. HAROLD PATINO
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 2760 FORGUE DR SUITE 106
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City | NAPERVILLE
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State | IL
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Zip | 60564-4173
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Country | US
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Telephone | 630-536-1900
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Fax | 630-536-1906
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Provider Business Mailing Address
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Address Line | 624 FAWELL COURT
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City | NAPERVILLE
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State | IL
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Zip | 60565
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Country | US
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Telephone | 630-428-4228
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 021001993
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License Number State | IL
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