Provider Demographics
NPI:1134117252
Name:COLLINS, BOBBY MCMANUS II (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:MCMANUS
Last Name:COLLINS
Suffix:II
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:2008 CROOKED CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8432
Mailing Address - Country:US
Mailing Address - Phone:252-737-7021
Mailing Address - Fax:252-737-7049
Practice Address - Street 1:1851 MACGREGOR DOWNS RD
Practice Address - Street 2:EAST CAROLINA UNIVERSITY SCHOOL OF DENTAL MEDICINE
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5925
Practice Address - Country:US
Practice Address - Phone:252-737-7021
Practice Address - Fax:252-737-7049
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC51361223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1638417Medicaid
PAU67065Medicare UPIN