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NPI Code Detail

MEDICARE: DR. JOSE ERNESTO COLON D.M.D., D.M.SC.

MEDICARE: DR. JOSE ERNESTO COLON D.M.D., D.M.SC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0106XOral and Maxillofacial Pathology Dentistry2005PR

General Provider Information

NPI Number : 1881678944
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE ERNESTO COLON D.M.D., D.M.SC.
Provider Business Mailing Address
First Line : 8101 EASTERN AVE
Second Line : APT. A-313
City : SILVER SPRING
State : MD
Zip : 20910-3156
Country : US
Telephone Number : 301-920-0015
Fax Number :
Provider Business Practice Location Address
First Line : 6825 16TH ST NW
Second Line : BLDG #54, RM. 3055
City : WASHINGTON
State : DC
Zip : 20306-0003
Country : US
Telephone Number : 202-782-1805
Fax Number : 202-782-3140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 07/18/2008

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