Provider Demographics
NPI:1922011923
Name:COLLINS, ANDREW P (D M D)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:COLLINS
Suffix:
Gender:M
Credentials:D M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2652
Mailing Address - Country:US
Mailing Address - Phone:919-489-2394
Mailing Address - Fax:919-489-2395
Practice Address - Street 1:3115 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2652
Practice Address - Country:US
Practice Address - Phone:919-489-2394
Practice Address - Fax:919-489-2395
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics