Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | 2006015357 | MO |
N | 1223P0300X | Periodontist | 2261 | HI |
Y | 1223P0300X | Periodontist | D7714 | AZ |
NPI | 1124267232 |
---|---|
Provider Name | Aaron James Colby |
First Address | Scottsdale, AZ 85254-6452 |
Second Address | Scottsdale, AZ 85254-6452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2009 |
Last Update Date | 12/02/2009 |