Provider Demographics
NPI:1477677060
Name:COLAHAN, BARTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARTT
Middle Name:
Last Name:COLAHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 EXECUTIVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857
Mailing Address - Country:US
Mailing Address - Phone:419-668-6589
Mailing Address - Fax:419-663-4601
Practice Address - Street 1:54 EXECUTIVE DRIVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857
Practice Address - Country:US
Practice Address - Phone:419-668-6589
Practice Address - Fax:419-663-4601
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0204861223G0001X
OH30-0204861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice