Provider Demographics
NPI:1205511714
Name:PATTON, COLBY JOHN (DMD)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:JOHN
Last Name:PATTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 E GILLESPIE LN
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8612
Mailing Address - Country:US
Mailing Address - Phone:775-934-3802
Mailing Address - Fax:
Practice Address - Street 1:6109 E HIGHWAY 191
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5348
Practice Address - Country:US
Practice Address - Phone:432-272-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7833122300000X
TX41913122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty