Healthcare Provider Details

I. General information

NPI: 1073727772
Provider Name (Legal Business Name): JOBY DAVIS COLLINS D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60024 OLIVE ST
SMITHVILLE MS
38870-9719
US

IV. Provider business mailing address

PO BOX 205
SMITHVILLE MS
38870-0205
US

V. Phone/Fax

Practice location:
  • Phone: 662-651-7111
  • Fax: 662-651-7115
Mailing address:
  • Phone: 662-651-7111
  • Fax: 662-651-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2715-93
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: