Provider Demographics
NPI:1689757932
Name:MAYERS, COLIN A (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:A
Last Name:MAYERS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-8314
Mailing Address - Country:US
Mailing Address - Phone:517-439-1461
Mailing Address - Fax:517-439-5718
Practice Address - Street 1:1426 HUDSON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-8314
Practice Address - Country:US
Practice Address - Phone:517-439-1461
Practice Address - Fax:517-439-5718
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI115051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics