# DOMENICK COLETTI DDS, MD, PC

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

## Provider details

- **NPI number:** 1477881290
- **Authorized official:** DOMENICK COLETTI DDS, MD, FACS (PRESIDENT)
- **Authorized official phone:** (410) 997-1010

## Contact information

- **Practice address:** 10710 CHARTER DR, SUITE 330, COLUMBIA, MD 21044-3128
- **Practice address phone:** (410) 997-1010
- **Practice address fax:** (410) 997-0807
- **Mailing address:** 10710 CHARTER DR, SUITE 330, COLUMBIA, MD 21044-3128
- **Mailing address phone:** (410) 997-1010
- **Mailing address fax:** (410) 997-0807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | D0060424 | MD | Yes |

## Other

- **Enumeration date:** 12/07/2009
- **Last updated:** 12/07/2009