Provider Demographics
NPI:1619052057
Name:ROBERT W PATTEN DDS PC
Entity Type:Organization
Organization Name:ROBERT W PATTEN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:PATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-522-5535
Mailing Address - Street 1:112 DELMAR STREET
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751
Mailing Address - Country:US
Mailing Address - Phone:970-522-5535
Mailing Address - Fax:970-522-6942
Practice Address - Street 1:112 DELMAR STREET
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751
Practice Address - Country:US
Practice Address - Phone:970-522-5535
Practice Address - Fax:970-522-6942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty