Provider Demographics
NPI:1477969251
Name:COLELLA, BRITLY (DMD)
Entity type:Individual
Prefix:DR
First Name:BRITLY
Middle Name:
Last Name:COLELLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SPRING CRESS LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1782
Mailing Address - Country:US
Mailing Address - Phone:309-212-7036
Mailing Address - Fax:309-212-7036
Practice Address - Street 1:26W276 GENEVA RD STE E
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2228
Practice Address - Country:US
Practice Address - Phone:630-556-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist