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NPI Code Detail

MEDICARE: DR. CRAIG STANLEY COLAS DDS

MEDICARE: DR. CRAIG STANLEY COLAS DDS
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
1122300000XDentist038841NY

General Provider Information

NPI Number : 1174680391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG STANLEY COLAS DDS
Provider Business Mailing Address
First Line : 1320 CAMERON LN
Second Line :
City : VESTAL
State : NY
Zip : 13850-5559
Country : US
Telephone Number : 607-773-9079
Fax Number :
Provider Business Practice Location Address
First Line : 249 GLENWOOD RD
Second Line :
City : BINGHAMTON
State : NY
Zip : 13905-1603
Country : US
Telephone Number : 607-770-0363
Fax Number : 607-770-0443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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