Individual
DR. TAHISA PATRIC COLBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1006 SURREY ST, LAFAYETTE, LA 70501-6143
(337) 234-0411
Mailing address
113 DERBY LN, LAFAYETTE, LA 70508-5977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5321
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1853216
—
LA
Enumeration date
11/20/2006
Last updated
07/09/2007
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