Provider Demographics
NPI:1023186475
Name:ROBERT COLLIER D.D.S., L.L.C.
Entity Type:Organization
Organization Name:ROBERT COLLIER D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-297-7263
Mailing Address - Street 1:6650 N. ORACLE RD. STE. 120
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5604
Mailing Address - Country:US
Mailing Address - Phone:520-297-7263
Mailing Address - Fax:
Practice Address - Street 1:6650 N ORACLE RD STE 120
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5604
Practice Address - Country:US
Practice Address - Phone:520-297-7263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-02
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty