Healthcare Provider Details

I. General information

NPI: 1700301553
Provider Name (Legal Business Name): COLIN EGAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2017
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 BENJAMIN PKWY STE A
GREENSBORO NC
27408-2016
US

IV. Provider business mailing address

1602 BENJAMIN PKWY STE A
GREENSBORO NC
27408-2016
US

V. Phone/Fax

Practice location:
  • Phone: 336-288-0010
  • Fax:
Mailing address:
  • Phone: 336-288-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number14395
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: