Provider Demographics
NPI:1376552158
Name:COLLIER, JOHN M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:COLLIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1771 INDEPENDENCE CT STE 3
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1232
Mailing Address - Country:US
Mailing Address - Phone:205-870-9441
Mailing Address - Fax:205-870-9442
Practice Address - Street 1:1771 INDEPENDENCE CT STE 3
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-1232
Practice Address - Country:US
Practice Address - Phone:205-870-9441
Practice Address - Fax:205-870-9442
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL46891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics