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NPI Code Detail

MEDICARE: DR. BOBBY MCMANUS COLLINS II DDS, MS

MEDICARE: DR. BOBBY MCMANUS COLLINS II DDS, MS
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
11223P0106XOral and Maxillofacial Pathology Dentistry5136NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134117252
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BOBBY MCMANUS COLLINS II DDS, MS
Provider Business Mailing Address
First Line : 2008 CROOKED CREEK RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-8432
Country : US
Telephone Number : 252-737-7021
Fax Number : 252-737-7049
Provider Business Practice Location Address
First Line : 1851 MACGREGOR DOWNS RD
Second Line : EAST CAROLINA UNIVERSITY SCHOOL OF DENTAL MEDICINE
City : GREENVILLE
State : NC
Zip : 27834-5925
Country : US
Telephone Number : 252-737-7021
Fax Number : 252-737-7049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 12/10/2012

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