MEDICARE: DR. AARON DAVID COLLINS DDS

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	1223P0221X	Pediatric Dentistry	21365	TX

General Provider Information

NPI Number	:	1265567960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON DAVID COLLINS DDS

Provider Business Mailing Address
First Line	:	1910 W 35TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-1324
Country	:	US
Telephone Number	:	512-451-8310
Fax Number	:	512-451-8310

Provider Business Practice Location Address
First Line	:	1910 W 35TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-1324
Country	:	US
Telephone Number	:	512-451-8310
Fax Number	:	512-451-8310

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/09/2007

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