Provider Demographics
NPI:1003936873
Name:COLLINS, PAUL GERDEN (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GERDEN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28318 DUPONT BLVD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966
Mailing Address - Country:US
Mailing Address - Phone:302-934-8005
Mailing Address - Fax:302-934-6824
Practice Address - Street 1:28318 DUPONT BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966
Practice Address - Country:US
Practice Address - Phone:302-934-8005
Practice Address - Fax:302-934-6824
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG100009361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice