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NPI Code Detail

MEDICARE: AMANDA COLLINS

MEDICARE:   AMANDA  COLLINS
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
1124Q00000XDental Hygienist5939675-9920UT

General Provider Information

NPI Number : 1154542074
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA COLLINS
Provider Business Mailing Address
First Line : 1844 E 9400 S
Second Line :
City : SANDY
State : UT
Zip : 84093-3000
Country : US
Telephone Number : 801-816-9366
Fax Number :
Provider Business Practice Location Address
First Line : 1844 E 9400 S
Second Line :
City : SANDY
State : UT
Zip : 84093-3000
Country : US
Telephone Number : 801-816-9366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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Directions to “ AMANDA COLLINS ” Practice Location

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