Individual
DR. JUSTIN COLGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2850 LONE OAK RD STE 1, PADUCAH, KY 42003-8043
(270) 554-3131
Mailing address
2850 LONE OAK RD STE 1, PADUCAH, KY 42003-8043
(270) 556-0189
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10050
KY
1223P0221X
Pediatric Dentistry
Primary
10050
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2016
Last updated
03/30/2018
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