Provider Demographics
NPI:1285635011
Name:COLM, STEPHEN J (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:COLM
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:5634 W IDA DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-5136
Mailing Address - Country:US
Mailing Address - Phone:303-347-0597
Mailing Address - Fax:303-707-1301
Practice Address - Street 1:1050 S 8TH ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-1307
Practice Address - Country:US
Practice Address - Phone:719-635-2807
Practice Address - Fax:719-635-2965
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2012-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO70091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery