National Provider Identifier
Surendra Pattathan, DDS
Surendra Pattathan, DDS is listed in the NPPES registry with a primary specialty of Dentist in Brocton, NY and a listed phone number of (631) 790-4083.
Profile Overview
- NPI
- 1023863636
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- April 18, 2024
- Last Updated
- April 18, 2024
Practice Location
- 9300 Lake Ave
- Brocton, NY 14716-9621
Phone: (631) 790-4083
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1023863636
- Entity Type
- Individual
- Last Name
- Pattathan
- First Name
- Surendra
- Credential
- DDS
- Mailing Street Address
- 9300 Lake Ave
- Mailing City
- Brocton
- Mailing State
- NY
- Mailing ZIP Code
- 14716-9621
- Mailing Country
- US
- Mailing Phone
- (716) 792-7100
- Practice Street Address
- 9300 Lake Ave
- Practice City
- Brocton
- Practice State
- NY
- Practice ZIP Code
- 14716-9621
- Practice Country
- US
- Practice Phone
- (631) 790-4083
- Enumeration Date
- April 18, 2024
- Last Updated
- April 18, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 18, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)