Individual
CODY BURNELL COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3 COUNTY ROAD 6523, KIRTLAND, NM 87417-9452
(505) 598-6800
Mailing address
6440 RIMVIEW PL, FARMINGTON, NM 87402-3086
(443) 742-8370
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2872
NM
Other
Enumeration date
03/13/2007
Last updated
08/11/2011
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