Provider Demographics
NPI:1730279837
Name:COLEMAN, JAMES RUTLEDGE JR (DMD, LLC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RUTLEDGE
Last Name:COLEMAN
Suffix:JR
Gender:M
Credentials:DMD, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SALTWIND CIR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-3067
Mailing Address - Country:US
Mailing Address - Phone:904-386-8216
Mailing Address - Fax:912-264-2409
Practice Address - Street 1:6602 ABERCORN ST STE 101
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5849
Practice Address - Country:US
Practice Address - Phone:912-354-3444
Practice Address - Fax:912-264-2409
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0153211223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty