Provider Demographics
NPI:1124120415
Name:COLBY, WILLIAM B (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:COLBY
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 FRANCE AVE S STE 504
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4549
Mailing Address - Country:US
Mailing Address - Phone:952-831-1324
Mailing Address - Fax:952-831-1560
Practice Address - Street 1:7373 FRANCE AVE S STE 504
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4549
Practice Address - Country:US
Practice Address - Phone:952-831-1324
Practice Address - Fax:952-831-1560
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40567801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics