Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6650 | CO |
NPI | 1073681441 |
---|---|
Provider Name | Dr. Kevin M Patterson |
First Address | Denver, CO 80246-1518 |
Second Address | Denver, CO 80246-1518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 10/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02066504 | (05) | CO |
U66598 | (02) | CO |