Provider Demographics
NPI:1659452886
Name:COLLINS & MONTZ, D.M.D., P.A.
Entity Type:Organization
Organization Name:COLLINS & MONTZ, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:J.
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:321-725-6565
Mailing Address - Street 1:524 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2524
Mailing Address - Country:US
Mailing Address - Phone:321-725-6565
Mailing Address - Fax:321-722-3871
Practice Address - Street 1:524 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32951-2524
Practice Address - Country:US
Practice Address - Phone:321-725-6565
Practice Address - Fax:321-722-3871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14275122300000X
FL14467122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty