Individual
JERRY E PATTERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2823 N DUKE ST, DURHAM, NC 27704-2621
(919) 479-0707
(919) 479-5435
Mailing address
2823 N DUKE ST, DURHAM, NC 27704-2621
(919) 479-0707
(919) 479-5435
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3213
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89-96677
—
NC
01
—
96677
BCBS PROVIDER ID
NC
Enumeration date
04/27/2006
Last updated
07/08/2007
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