Individual
DR. JOHN ANTHONY COLGAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2850 LONE OAK RD STE 1, PADUCAH, KY 42003-8043
(270) 554-5437
Mailing address
2850 LONE OAK RD STE 1, PADUCAH, KY 42003-8043
(270) 554-3131
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9215
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100218260
—
KY
Enumeration date
07/17/2012
Last updated
02/03/2016
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