Colton Cannon
Dentist in La Grange Park, IL. Individual provider (NPI-1).
NPI number1801590807
StatusActive
Last updated in NPPESJul 9, 2026
Details
- NPI
- 1801590807
- Entity type
- Individual (NPI-1)
- Name
- Colton Cannon
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2023
- Certification date
- Jul 9, 2026
- Last updated
- Jul 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 019.035872 | IL | Yes |
Practice location
539 N La Grange RdLa Grange Park, IL 60526-5647
Phone 708-354-1070
Mailing address
3400 Spruce StPhiladelphia, PA 19104-4238
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All 10 Dentist providers in La Grange Park · All 265 providers in La Grange Park
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