Provider Demographics
NPI:1225048424
Name:SHANDON M. COLTER, D.D.S., PA
Entity Type:Organization
Organization Name:SHANDON M. COLTER, D.D.S., PA
Other - Org Name:GLASER, JONES AND COLTER, D.D.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANDON
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-386-6200
Mailing Address - Street 1:5408 ALPHA RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4506
Mailing Address - Country:US
Mailing Address - Phone:972-386-6200
Mailing Address - Fax:
Practice Address - Street 1:5408 ALPHA RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4506
Practice Address - Country:US
Practice Address - Phone:972-386-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty