# COLONIAL HEIGHTS DENTAL ASSOCAITES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467567412
- **Authorized official:** DR. BARTLEY LYNN FORD DDS, FAGD (DENTIST/PRESIDENT)
- **Authorized official phone:** (423) 239-8021

## Contact information

- **Practice address:** 150 CLINIC DRIVE, SUITE A, KINGSPORT, TN 37663
- **Practice address phone:** (423) 239-8021
- **Practice address fax:** (423) 239-6273
- **Mailing address:** 150 CLINIC DRIVE, SUITE A, KINGSPORT, TN 37663
- **Mailing address phone:** (423) 239-8021
- **Mailing address fax:** (423) 239-6273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS-00004556 | TN | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 08/22/2020