Individual
DR. CHARLES DOUGLAS KOLB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1210 GREGORY ST STE 3, TAFT, TX 78390-3045
(361) 528-3262
(361) 528-2016
Mailing address
PO BOX 212, 1210 GREGORY ST. STE. #3, 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
—
0091290-01
—
TX
01
—
715424
TRICARE
TX
Enumeration date
01/15/2007
Last updated
06/12/2024
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