Individual
DR. JOHN HENRY COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1162 S LINE ST, GRENADA, MS 38901-4239
(662) 226-0585
(662) 226-0586
Mailing address
1162 S LINE ST, GRENADA, MS 38901-4239
(662) 226-0585
(662) 226-0586
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
196682
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064983
—
MS
Enumeration date
11/08/2006
Last updated
07/08/2007
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