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General NPI Number Information
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NPI Number | 1164502944
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Entity Type | Individual
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Provider Name | WILLIAM BAXTER COLLIER JR. DMD
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 442 GLOVER AVE
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City | ENTERPRISE
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State | AL
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Zip | 36330
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Country | US
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Telephone | 334-347-5026
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Fax | 334-347-0117
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Provider Business Mailing Address
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Address Line | PO BOX 311110
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City | ENTERPRISE
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State | AL
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Zip | 36331-1110
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Country | US
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Telephone | 334-347-5026
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Fax | 334-347-0117
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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 | 2608
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License Number State | AL
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