Provider Demographics
NPI:1013324938
Name:COLLIE, CHRISTOPHER JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:COLLIE
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 1:5204 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1500
Mailing Address - Country:US
Mailing Address - Phone:804-282-3838
Mailing Address - Fax:804-282-3874
Practice Address - Street 1:5204 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1500
Practice Address - Country:US
Practice Address - Phone:804-282-3838
Practice Address - Fax:804-282-3874
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9963122300000X
VA0401414786122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9963OtherNC BOARD OF DENTAL EXAMINERS
VA0401414786OtherVA BOARD OF DENTISTRY