Organization
COLGAN PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MICHELLE WALLS (OFFICE MANAGER)
(270) 554-3131
Entity
Organization
Contact information
Practice address
2850 LONE OAK RD STE 1, PADUCAH, KY 42003-8043
(270) 554-0124
(270) 554-0124
Mailing address
2850 LONE OAK RD STE 1, PADUCAH, KY 42003-8043
(270) 554-0124
(270) 554-0124
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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