Provider Demographics
NPI:1114034741
Name:PATTON, JOHN STUART (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STUART
Last Name:PATTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 HARGROVE ROAD EAST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401
Mailing Address - Country:US
Mailing Address - Phone:205-759-1000
Mailing Address - Fax:205-752-2570
Practice Address - Street 1:610 HARGROVE ROAD EAST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401
Practice Address - Country:US
Practice Address - Phone:205-759-1000
Practice Address - Fax:205-752-2570
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist