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General NPI Number Information
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NPI Number | 1922131473
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Entity Type | Individual
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Provider Name | SHARON YVETTE COLVIN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 12025 CALICO WOODS PL
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City | WALDORF
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State | MD
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Zip | 20601-7260
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Country | US
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Telephone | 757-618-0519
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Fax | 888-492-9434
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Provider Business Mailing Address
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Address Line | 12025 CALICO WOODS PL
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City | WALDORF
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State | MD
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Zip | 20601-7260
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Country | US
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Telephone | 757-618-0519
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Fax | 888-492-9434
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401008133
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN1001059
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15159
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License Number State | MD
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