Individual
DR. DANIEL JAMES PATTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
439 N JACKSON ST STE E, BROOKHAVEN, MS 39601-2912
(601) 833-0777
(601) 833-6606
Mailing address
103 NOBLE DR, BROOKHAVEN, MS 39601-3623
(601) 833-0207
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2095-84
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07831757
—
MS
01
—
839931
UNITED CONCORDIA
MS
Enumeration date
10/05/2006
Last updated
11/15/2007
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