Individual
DR. KENNETH E PATTERSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1411 FILLMORE ST STE 601, TWIN FALLS, ID 83301-3343
(208) 733-2300
(208) 736-7214
Mailing address
1411 FILLMORE ST STE 601, TWIN FALLS, ID 83301-3343
(208) 733-2300
(208) 736-7214
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1788
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001184500
—
ID
05
—
002288154
—
NV
Enumeration date
01/23/2007
Last updated
06/17/2008
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