Provider Demographics
NPI:1073575056
Name:JOHN A COLLINS JR DDS INC.
Entity Type:Organization
Organization Name:JOHN A COLLINS JR DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-966-3000
Mailing Address - Street 1:27 MENDON STREET
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-1522
Mailing Address - Country:US
Mailing Address - Phone:508-966-3000
Mailing Address - Fax:508-966-3651
Practice Address - Street 1:27 MENDON ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-1555
Practice Address - Country:US
Practice Address - Phone:508-966-3000
Practice Address - Fax:508-966-3651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty