Individual
JEREMY TODD COLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3750 W GREENWAY RD, PHOENIX, AZ 85053-3703
(602) 466-2202
Mailing address
18620 N 4TH AVE, PHOENIX, AZ 85027-5665
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010056
AZ
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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