Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2957 | AR |
N | 1223P0221X | Pediatric Dentist | 36 | AR |
NPI | 1063573780 |
---|---|
Provider Name | Alma Elizabeth Patterson |
First Address | Searchy, AR 72143-5206 |
Second Address | Searchy, AR 72143-5206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |