Provider Demographics
NPI:1285830703
Name:COLLETTE, JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:COLLETTE
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 1:2611 S QUILLAN PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1899
Mailing Address - Country:US
Mailing Address - Phone:509-585-5437
Mailing Address - Fax:509-585-5438
Practice Address - Street 1:2611 S QUILLAN PL
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1899
Practice Address - Country:US
Practice Address - Phone:509-585-5437
Practice Address - Fax:509-585-5438
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH25871223P0221X
WADE600800121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry