Organization
CHARLES D KOLB DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DOUGLAS KOLB DDS (OWNER DOCTOR)
(361) 528-3262
Entity
Organization
Contact information
Practice address
1210 GREGORY ST, STE 3, TAFT, TX 78390-0212
(361) 528-3262
(361) 528-2016
Mailing address
PO BOX 212, TAFT, TX 78390-0212
(361) 528-3262
(361) 528-2016
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9333
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009129001
—
TX
01
—
G6016501
CHIP
TX
Enumeration date
06/02/2008
Last updated
06/02/2008
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