Provider Demographics
NPI:1619058450
Name:COLLIER, OLIVIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 BROADWAY ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2953
Mailing Address - Country:US
Mailing Address - Phone:360-738-9791
Mailing Address - Fax:
Practice Address - Street 1:1310 BROADWAY SUITE 1-A
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2953
Practice Address - Country:US
Practice Address - Phone:360-738-9791
Practice Address - Fax:360-738-9869
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist