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General NPI Number Information
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NPI Number | 1205859345
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Entity Type | Individual
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Provider Name | JOHN CHRISTOPHER COLLIAS DDS
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 45 EAST BEACH DRIVE, PANAMA CITY, FL, USA
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City | PANAMA CITY
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State | FL
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Zip | 32401-3240
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Country | US
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Telephone | 850-501-0761
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Fax |
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Provider Business Mailing Address
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Address Line | 45 EAST BEACH DRIVE, PANAMA CITY, FL, USA
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City | PANAMA CITY
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State | FL
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Zip | 32401-5242
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Country | US
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Telephone | 850-785-5502
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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 | 47704
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License Number State | CA
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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 | DN16143
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License Number State | FL
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