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General NPI Number Information
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NPI Number | 1922694314
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Entity Type | Organization
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Legal Business Name | PATTON DENTAL
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Dates
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Enumeration Date | 12/19/2020
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Last Update Date | 12/19/2020
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Provider Practice Location Address
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Address Line | 1110 W GRAY ST STE 220
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City | HOUSTON
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State | TX
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Zip | 77019-4133
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Country | US
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Telephone | 281-768-8944
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Fax | 281-768-8921
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Provider Business Mailing Address
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Address Line | 1110 W GRAY ST STE 220
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City | HOUSTON
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State | TX
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Zip | 77019-4133
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Country | US
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Telephone | 281-768-8944
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Fax | 281-768-8921
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Authorized Official
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Title or Position | EXECUTIVE MANAGER
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Name | JASON PATTON
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Credential | JD
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Telephone | 512-800-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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