Provider Demographics
NPI:1982056461
Name:COLBERT, CAITLIN (DDS)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:COLBERT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:BUMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 N 25TH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 N 25TH ST
Practice Address - Street 2:SUITE 101M
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1328
Practice Address - Country:US
Practice Address - Phone:406-248-6177
Practice Address - Fax:406-248-1556
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist