Provider Demographics
NPI:1679501589
Name:DR JAMES G KOLLAR DDS
Entity Type:Organization
Organization Name:DR JAMES G KOLLAR DDS
Other - Org Name:DR JAMES G KOLLAR DR CORRINE KOLLAR-FURY DR TODD C ALEXANDER
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:KOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-981-4270
Mailing Address - Street 1:2200 EAST STATE ST
Mailing Address - Street 2:PO BOX 1420
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148
Mailing Address - Country:US
Mailing Address - Phone:724-981-4270
Mailing Address - Fax:724-981-8711
Practice Address - Street 1:2200 EAST STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148
Practice Address - Country:US
Practice Address - Phone:724-981-4270
Practice Address - Fax:724-981-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS16085L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty