Provider Demographics
NPI:1093853236
Name:COLLINS, SCHARLA RUSK (DDS)
Entity Type:Individual
Prefix:
First Name:SCHARLA
Middle Name:RUSK
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2758 N GALLOWAY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150
Mailing Address - Country:US
Mailing Address - Phone:972-270-5113
Mailing Address - Fax:972-270-5157
Practice Address - Street 1:2758 N GALLOWAY AVE
Practice Address - Street 2:STE 200
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:972-270-5113
Practice Address - Fax:972-270-5157
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice