MEDICARE: JOHN A COLLINS JR DDS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	11451	MA

General Provider Information

NPI Number	:	1073575056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN A COLLINS JR DDS INC.

Provider Business Mailing Address
First Line	:	27 MENDON STREET
Second Line	:
City	:	BELLINGHAM
State	:	MA
Zip	:	02019-1522
Country	:	US
Telephone Number	:	508-966-3000
Fax Number	:	508-966-3651

Provider Business Practice Location Address
First Line	:	27 MENDON ST
Second Line	:
City	:	BELLINGHAM
State	:	MA
Zip	:	02019-1555
Country	:	US
Telephone Number	:	508-966-3000
Fax Number	:	508-966-3651

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN A COLLINS JR.
Credential	:	DDS
Telephone Number	:	508-966-3000

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	08/22/2020

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