Provider Demographics
NPI:1154453124
Name:CALHOUN, COLONYA CHAROLYNN (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:COLONYA
Middle Name:CHAROLYNN
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29949 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1947
Mailing Address - Country:US
Mailing Address - Phone:310-850-3579
Mailing Address - Fax:
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1078
Practice Address - Country:US
Practice Address - Phone:734-764-1542
Practice Address - Fax:734-615-1415
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531951223S0112X
MI29010178401223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery