Charles, Colton

Charles, Colton is an individual health care provider with primary practice located at 450 W State St Ste 180 , Eagle ID 83616-6974. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Charles, Colton can be contacted via phone (208) 939-0600.

Contact Information

Primary practice address
450 W State St Ste 180 Eagle ID 83616-6974
Phone: (208) 939-0600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D4320 Idaho

Profile Details

NPI number 1073826772
LBN Legal business name Charles, Colton
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2010
Last updated Jun 17th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073826772 NPPES
Idaho Other D-4320 STATE LICENSE

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