Provider Demographics
NPI:1891806253
Name:COLLINS HALE, EDWINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWINA
Middle Name:
Last Name:COLLINS HALE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 OLD HICKORY BLVD
Mailing Address - Street 2:STE 205
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4239
Mailing Address - Country:US
Mailing Address - Phone:615-331-1111
Mailing Address - Fax:615-333-0200
Practice Address - Street 1:1195 OLD HICKORY BLVD
Practice Address - Street 2:STE 205
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4239
Practice Address - Country:US
Practice Address - Phone:615-331-1111
Practice Address - Fax:615-333-0200
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8142122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist