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NPI Code Detail

MEDICARE: DR. COLTON PAUL MITCHELL DMD

MEDICARE: DR. COLTON PAUL MITCHELL DMD
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
1122300000XDentist39026TX

General Provider Information

NPI Number : 1588391544
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COLTON PAUL MITCHELL DMD
Provider Business Mailing Address
First Line : 4301 WILSON ST
Second Line :
City : FORT SILL
State : OK
Zip : 73503-4472
Country : US
Telephone Number : 580-558-2795
Fax Number :
Provider Business Practice Location Address
First Line : 605 RANDOLPH RD
Second Line :
City : FORT SILL
State : OK
Zip : 73503-4535
Country : US
Telephone Number : 580-442-2263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2022
Last Update Date : 06/30/2026

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