Provider Demographics
NPI:1104023506
Name:COLT, ROBERT B (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:COLT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7878 W 80TH PL
Mailing Address - Street 2:SUITE 2-D
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-2520
Mailing Address - Country:US
Mailing Address - Phone:303-421-2696
Mailing Address - Fax:303-421-2179
Practice Address - Street 1:7878 W 80TH PL
Practice Address - Street 2:SUITE 2-D
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-2520
Practice Address - Country:US
Practice Address - Phone:303-421-2696
Practice Address - Fax:303-421-2179
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8780122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist