Individual
PETER JOSEPH KOLETAR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3121 N MAIN ST, CROSSVILLE, TN 38555
(931) 484-9400
(931) 484-1477
Mailing address
3121 N MAIN ST, CROSSVILLE, TN 38555
(931) 484-9400
(931) 484-1477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000007173
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3204906
—
TX
Enumeration date
08/26/2006
Last updated
01/03/2008
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