Provider Demographics
NPI:1417018441
Name:COLT, S. GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:S. GEORGE
Middle Name:
Last Name:COLT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:SOCRATES GEORGE
Other - Middle Name:
Other - Last Name:COLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1650 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190
Mailing Address - Country:US
Mailing Address - Phone:781-331-9200
Mailing Address - Fax:781-331-9380
Practice Address - Street 1:1650 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-331-9200
Practice Address - Fax:781-331-9380
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA94681223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics