Provider Demographics
NPI:1972647709
Name:COLBERT, CURLES C JR (DDS)
Entity Type:Individual
Prefix:
First Name:CURLES
Middle Name:C
Last Name:COLBERT
Suffix:JR
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 1:30704 HUNTSMAN DR E
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331
Mailing Address - Country:US
Mailing Address - Phone:248-790-5744
Mailing Address - Fax:313-382-0050
Practice Address - Street 1:2041 FIFTEEN MILE RD
Practice Address - Street 2:GREAT EXPRESSIONS DENTAL CENTERS PC
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:586-268-0900
Practice Address - Fax:586-268-0546
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901012039122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist