Provider Demographics
NPI:1194989830
Name:PATTON, JOSEPH PARK (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PARK
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 1:1701 MCFARLAND BLVD E
Mailing Address - Street 2:122
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5824
Mailing Address - Country:US
Mailing Address - Phone:205-345-0547
Mailing Address - Fax:
Practice Address - Street 1:1701 MCFARLAND BLVD E
Practice Address - Street 2:122
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5824
Practice Address - Country:US
Practice Address - Phone:205-345-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5602122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist