Provider Demographics
NPI:1598856213
Name:COLLINS, NEIL A (DMD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 WINCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-1928
Mailing Address - Country:US
Mailing Address - Phone:606-324-1117
Mailing Address - Fax:
Practice Address - Street 1:2741 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-1928
Practice Address - Country:US
Practice Address - Phone:606-324-1117
Practice Address - Fax:606-324-2336
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice