Provider Demographics
NPI:1134339757
Name:COLSON, WILLIAM CHAD (DMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHAD
Last Name:COLSON
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 1:70 POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3506
Mailing Address - Country:US
Mailing Address - Phone:864-271-6705
Mailing Address - Fax:864-271-8940
Practice Address - Street 1:70 POINTE CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3506
Practice Address - Country:US
Practice Address - Phone:864-271-6705
Practice Address - Fax:864-271-8940
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice