NPI 1104276443

Katelynn Colburn

Practitioner Dentist Thibodaux, LA

Practice location

Address: 850 N Canal Blvd, Thibodaux, LA 70301-8076
Phone: (985) 447-4783
Mailing address: 721 Park Ridge Dr, River Ridge, LA 70123-1182

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 6688 (LA)

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Registry record

NPI: 1104276443
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Jun 2016
Record last updated: 17 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.