MEDICARE: COLLINS & MONTZ, D.M.D., P.A.

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	122300000X	Dentist	14467	FL
2	122300000X	Dentist	14275	FL

General Provider Information

NPI Number	:	1659452886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLINS & MONTZ, D.M.D., P.A.

Provider Business Mailing Address
First Line	:	524 OCEAN AVE
Second Line	:
City	:	MELBOURNE BEACH
State	:	FL
Zip	:	32951-2524
Country	:	US
Telephone Number	:	321-725-6565
Fax Number	:	321-722-3871

Provider Business Practice Location Address
First Line	:	524 OCEAN AVE
Second Line	:
City	:	MELBOURNE BEACH
State	:	FL
Zip	:	32951-2524
Country	:	US
Telephone Number	:	321-725-6565
Fax Number	:	321-722-3871

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. J. HUNTER COLLINS
Credential	:	D.M.D.
Telephone Number	:	321-725-6565

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	08/22/2020

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