Provider Demographics
NPI:1518088244
Name:MORTON, COLIN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:A
Last Name:MORTON
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 1:1 ROSELL DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1400
Mailing Address - Country:US
Mailing Address - Phone:518-877-8687
Mailing Address - Fax:518-877-8906
Practice Address - Street 1:1 ROSELL DR
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1400
Practice Address - Country:US
Practice Address - Phone:518-877-8687
Practice Address - Fax:518-877-8906
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0476711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice