=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831025501
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAL R. PATTON, D.D.S.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2026
-----------------------------------------------------
Last Update Date | 06/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1403 TROY RD STE B
-----------------------------------------------------
City | EDWARDSVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62025-2590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-656-2277
-----------------------------------------------------
Fax | 618-656-7732
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1403 TROY RD STE B
-----------------------------------------------------
City | EDWARDSVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62025-2590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-656-2277
-----------------------------------------------------
Fax | 618-656-7732
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. HAROLD R PATTON
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 618-656-2277
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------