Healthcare Provider Details

I. General information

NPI: 1881757086
Provider Name (Legal Business Name): MYRON HARRIS COULTON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 N FEDERAL HWY
POMPANO BEACH FL
33062-1003
US

IV. Provider business mailing address

1990 N FEDERAL HWY
POMPANO BEACH FL
33062-1003
US

V. Phone/Fax

Practice location:
  • Phone: 954-782-8620
  • Fax: 954-943-8506
Mailing address:
  • Phone: 954-782-8620
  • Fax: 954-943-8506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: