Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 2827 | WI |
NPI | 1033114723 |
---|---|
Provider Name | Dr. Scott Bradford Patterson |
First Address | Monroe, WI 53566-1747 |
Second Address | Monroe, WI 53566-1747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 08/07/2007 |