Provider Demographics
NPI:1932489226
Name:COLLINS, SEAN THOMAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:THOMAS
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:673 BEDFORD ST
Mailing Address - Street 2:#1
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-1921
Mailing Address - Country:US
Mailing Address - Phone:781-878-0001
Mailing Address - Fax:
Practice Address - Street 1:673 BEDFORD ST
Practice Address - Street 2:#1
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-1921
Practice Address - Country:US
Practice Address - Phone:781-878-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18557951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice