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General NPI Number Information
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NPI Number | 1124125885
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Entity Type | Individual
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Provider Name | ROBERT HARRIS COLLIER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 150 BROADWAY RM 1310
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City | NEW YORK
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State | NY
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Zip | 10038-4365
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Country | US
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Telephone | 212-587-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BROADWAY RM 1310
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City | NEW YORK
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State | NY
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Zip | 10038-4365
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Country | US
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Telephone | 212-587-0202
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Fax | 520-742-1311
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AZ2888
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 041638-1
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License Number State | NY
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