Organization
DOMENICK COLETTI DDS, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMENICK COLETTI DDS, MD, FACS (PRESIDENT)
(410) 997-1010
Entity
Organization
Contact information
Practice address
10710 CHARTER DR, SUITE 330, COLUMBIA, MD 21044-3128
(410) 997-1010
(410) 997-0807
Mailing address
10710 CHARTER DR, SUITE 330, COLUMBIA, MD 21044-3128
(410) 997-1010
(410) 997-0807
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D0060424
MD
Other
Enumeration date
12/07/2009
Last updated
12/07/2009
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