Individual
MRS. TERRY SUSETTE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
199 8TH DIVISION RD., SALOMON DENTAL CLINIC, FORT BENNING, GA 31905-7077
(706) 617-6851
Mailing address
5264 10TH ARMORED LOOP, FPO, AP 31905-7077
(773) 209-4832
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.010280
IL
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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