Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS035986 | PA |
NPI | 1033172671 |
---|---|
Provider Name | Sandra Patterson |
First Address | Altamonte Springs, FL 32714-7244 |
Second Address | Lower Burrell, PA 15068-3504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1009833460001 | (05) | PA |
1009833460003 | (05) | PA |
1009833460004 | (05) | PA |
1009833460005 | (05) | PA |
1009833460006 | (05) | PA |
1009833460008 | (05) | PA |
1009833460009 | (05) | PA |
1009833460010 | (05) | PA |
1009833460011 | (05) | PA |
1009833460012 | (05) | PA |
1009833460013 | (05) | PA |
1009833460014 | (05) | PA |
1009833460015 | (05) | PA |