MEDICARE: JAMES M COLLINS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16450	MA

General Provider Information

NPI Number	:	1003820416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M COLLINS DDS

Provider Business Mailing Address
First Line	:	12 MAIN ST
Second Line	:
City	:	SHELBURNE FALLS
State	:	MA
Zip	:	01370
Country	:	US
Telephone Number	:	413-625-2612
Fax Number	:	413-625-2590

Provider Business Practice Location Address
First Line	:	12 MAIN ST
Second Line	:
City	:	SHELBURNE FALLS
State	:	MA
Zip	:	01370
Country	:	US
Telephone Number	:	413-625-2612
Fax Number	:	413-625-2590

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/08/2007

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