Healthcare Provider Details

I. General information

NPI: 1932459260
Provider Name (Legal Business Name): DENISE YVONNE COLBERT D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SION FARM SUITE 1C ISLAND MEDICAL CENTER
CHRISTIANSTED VI
00823
US

IV. Provider business mailing address

PO BOX 1395
FREDERIKSTED VI
00841-1395
US

V. Phone/Fax

Practice location:
  • Phone: 340-719-9991
  • Fax: 340-719-8963
Mailing address:
  • Phone: 340-719-9991
  • Fax: 340-719-8963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number1020
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number135-PH
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: