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General NPI Number Information
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NPI Number | 1720049570
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Entity Type | Individual
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Provider Name | LAURA S. COLLIER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 348 2ND STREET, SUITE #200
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City | EXCELSIOR
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State | MN
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Zip | 55331
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Country | US
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Telephone | 952-474-6515
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Fax | 952-474-1206
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Provider Business Mailing Address
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Address Line | 348 2ND STREET SUITE #200
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City | EXCELSIOR
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State | MN
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Zip | 55331
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Country | US
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Telephone | 952-474-6515
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Fax | 952-474-1206
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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 | D11680
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License Number State | MN
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