Provider Demographics
NPI:1750521597
Name:JAMES H COLSON DDS, PA
Entity type:Organization
Organization Name:JAMES H COLSON DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:COLSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:DR
Authorized Official - Phone:919-231-6053
Mailing Address - Street 1:123 SUNNYBROOK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1827
Mailing Address - Country:US
Mailing Address - Phone:919-231-6053
Mailing Address - Fax:919-231-8085
Practice Address - Street 1:123 SUNNYBROOK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1827
Practice Address - Country:US
Practice Address - Phone:919-231-6053
Practice Address - Fax:919-231-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35401223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
91743OtherNC HEALTH CHOICE
NC89902G8Medicaid
NC8991743Medicaid
NC902G8OtherNC HEALTH CHOICE