Provider Demographics
NPI:1043509029
Name:PATTON, CHELSEY (DMD)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4759 FOX RUN RD
Mailing Address - Street 2:
Mailing Address - City:BUCKNER
Mailing Address - State:KY
Mailing Address - Zip Code:40010-8852
Mailing Address - Country:US
Mailing Address - Phone:502-222-0443
Mailing Address - Fax:
Practice Address - Street 1:4759 FOX RUN RD
Practice Address - Street 2:
Practice Address - City:BUCKNER
Practice Address - State:KY
Practice Address - Zip Code:40010-8852
Practice Address - Country:US
Practice Address - Phone:502-222-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9056122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist