Provider Demographics
NPI:1003820416
Name:COLLINS, JAMES M (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370
Mailing Address - Country:US
Mailing Address - Phone:413-625-2612
Mailing Address - Fax:413-625-2590
Practice Address - Street 1:12 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370
Practice Address - Country:US
Practice Address - Phone:413-625-2612
Practice Address - Fax:413-625-2590
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA164501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice