Provider Demographics
NPI:1881678944
Name:COLON, JOSE ERNESTO (DMD, DMSC)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ERNESTO
Last Name:COLON
Suffix:
Gender:M
Credentials:DMD, DMSC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8101 EASTERN AVE
Mailing Address - Street 2:APT. A-313
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3156
Mailing Address - Country:US
Mailing Address - Phone:301-920-0015
Mailing Address - Fax:
Practice Address - Street 1:6825 16TH ST NW
Practice Address - Street 2:BLDG #54, RM. 3055
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20306-0003
Practice Address - Country:US
Practice Address - Phone:202-782-1805
Practice Address - Fax:202-782-3140
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR20051223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology