MEDICARE: A. ELIZABETH PATTERSON, DMD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1568068427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A. ELIZABETH PATTERSON, DMD, PA

Provider Business Mailing Address
First Line	:	600 W ARCH AVE
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143-5206
Country	:	US
Telephone Number	:	501-268-1101
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W ARCH AVE
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143-5206
Country	:	US
Telephone Number	:	501-268-1101
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	MRS. FANNI GILBERT
Credential	:	RDA
Telephone Number	:	501-268-1101

Provider Enumeration Date	:	12/07/2020
Last Update Date	:	12/07/2020

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