Healthcare Provider Details
I. General information
NPI: 1417166760
Provider Name (Legal Business Name): WILLIAM S. COLLIER, DMD, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 CHURCH ST
ALLENTOWN NJ
08501-0176
US
IV. Provider business mailing address
30 CHURCH ST 30 CHURCH ST
ALLENTOWN NJ
08501-0176
US
V. Phone/Fax
- Phone: 609-259-2283
- Fax: 609-259-2843
- Phone: 609-259-2283
- Fax: 609-259-2843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 22DI01001900 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
WILLIAM
COLLIER
Title or Position: PRESIDENT
Credential: DMD
Phone: 609-259-2283