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General NPI Number Information
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NPI Number | 1538376520
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Entity Type | Individual
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Provider Name | ANA MARIA COLLANTES D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 510 W RANCHO VISTA BLVD
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City | PALMDALE
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State | CA
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Zip | 93551-3737
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Country | US
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Telephone | 661-273-0706
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Fax | 661-273-3118
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Provider Business Mailing Address
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Address Line | 44543 OVERLAND AVE
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City | LANCASTER
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State | CA
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Zip | 93536-6461
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Country | US
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Telephone | 661-723-5151
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Fax | 661-272-8932
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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 | 55658
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License Number State | CA
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