Individual
DR. MATTHEW THOMAS COLAIZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2042 SAINT CLAIR AVE, SAINT PAUL, MN 55105-1650
(651) 298-0024
(651) 695-2333
Mailing address
2042 SAINT CLAIR AVE, SAINT PAUL, MN 55105-1650
(651) 298-0024
(651) 695-2333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11657
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
648375500
MEDICAL ASSISTANCE, GMAC
MN
Enumeration date
05/22/2007
Last updated
07/08/2007
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