Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 17127 | MA |
NPI | 1649311184 |
---|---|
Provider Name | Dr. Timothy S Colton |
First Address | Norwell, MA 02061-1727 |
Second Address | Norwell, MA 02061-1727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0271454 | (05) | MA |
T57785 | (02) | MA |