Provider Demographics
NPI:1942987961
Name:ROWBERRY, COLBY LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:COLBY
Middle Name:LEE
Last Name:ROWBERRY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 NORTHMOOR TRCE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-9323
Mailing Address - Country:US
Mailing Address - Phone:208-534-8005
Mailing Address - Fax:
Practice Address - Street 1:5400 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4210
Practice Address - Country:US
Practice Address - Phone:336-645-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist