Individual
DR. COLTON JOHN STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
2736 82ND ST, LUBBOCK, TX 79423-1428
(806) 745-3381
Mailing address
2736 82ND ST, LUBBOCK, TX 79423-1428
(806) 745-3381
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23908
TX
Other
Enumeration date
06/02/2008
Last updated
07/30/2010
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