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General NPI Number Information
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NPI Number | 1861534885
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Entity Type | Individual
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Provider Name | CHRIS D PATTON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1340 IMPERIAL BEACH BLVD SUITE 202
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-3046
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Country | US
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Telephone | 619-429-6600
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Fax | 619-429-1939
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Provider Business Mailing Address
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Address Line | 3253 MOUNT TAMI DR
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City | SAN DIEGO
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State | CA
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Zip | 92111-4634
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Country | US
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Telephone | 858-560-1461
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Fax | 858-560-2001
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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 | 35442
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License Number State | CA
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