Provider Demographics
NPI:1164597985
Name:COLBERT, DIONNE MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:MICHELLE
Last Name:COLBERT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317
Mailing Address - Country:US
Mailing Address - Phone:404-378-0499
Mailing Address - Fax:
Practice Address - Street 1:570 W LANIER AVE SUITE 100
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:678-836-2128
Practice Address - Fax:770-460-7307
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0118081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice