Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colton Lawrence Fowlkes

Individual provider Pediatric Dentistry · NPI 1558950964

Colton Lawrence Fowlkes is a Pediatric Dentistry in Marietta, Georgia. Works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

880 Canton Rd NE Ste 100
Marietta, GA 30060-7283
Phone: (770) 422-8264
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Freedom Way, Augusta, GA 30904-6258 — (706) 733-0188

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DN122221 (GA)
General Practice Dentistry Taxonomy 1223G0001X · Licence DN122221 (GA)

Record details

NPI number1558950964
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 12, 2021
Last updated in NPPESFebruary 4, 2025
Certification dateFebruary 4, 2025

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