Provider Demographics
NPI:1689816332
Name:SCHARLA R COLLINS DDS PA
Entity Type:Organization
Organization Name:SCHARLA R COLLINS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCHARLA
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-270-5113
Mailing Address - Street 1:2758 N GALLOWAY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6380
Mailing Address - Country:US
Mailing Address - Phone:972-270-5113
Mailing Address - Fax:972-270-5157
Practice Address - Street 1:2758 N GALLOWAY AVE
Practice Address - Street 2:STE 200
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6380
Practice Address - Country:US
Practice Address - Phone:972-270-5113
Practice Address - Fax:972-270-5157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20102122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty