Organization
DR DANIEL J PATTI D.M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J PATTI D.M.D. (OWNER)
(601) 833-0777
Entity
Organization
Contact information
Practice address
439 NORTH JACKSON ST., SUITE E, BROOKHAVEN, MS 39601-2912
(601) 833-0777
(601) 833-6606
Mailing address
439 NORTH JACKSON ST., SUITE E, BROOKHAVEN, MS 39601-2912
(601) 833-0777
(601) 833-6606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07831757
—
MS
Enumeration date
12/03/2010
Last updated
12/03/2010
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