Provider Demographics
NPI:1982273397
Name:MAHARRY, COLTON (DDS)
Entity Type:Individual
Prefix:
First Name:COLTON
Middle Name:
Last Name:MAHARRY
Suffix:
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 1:912 45TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-2204
Mailing Address - Country:US
Mailing Address - Phone:515-201-1967
Mailing Address - Fax:
Practice Address - Street 1:105 W MERLE HIBBS BLVD
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4795
Practice Address - Country:US
Practice Address - Phone:641-326-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-098961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice