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General NPI Number Information
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NPI Number | 1073586947
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Entity Type | Individual
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Provider Name | DORIS E. COLLINS DMD
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Gender | Female
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 15736 FIELDCREST CT
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City | GRANGER
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State | IN
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Zip | 46530-6537
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Country | US
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Telephone | 574-387-4663
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Fax |
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Provider Business Mailing Address
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Address Line | 15736 FIELDCREST CT
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City | GRANGER
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State | IN
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Zip | 46530-6537
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Country | US
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Telephone | 574-387-4663
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12012196A
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License Number State | IN
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