Provider Demographics
NPI:1023691094
Name:KANDACE R COLLINS DDS, PC
Entity type:Organization
Organization Name:KANDACE R COLLINS DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-866-2315
Mailing Address - Street 1:6601 COUNTY ROAD 305B
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76050-3002
Mailing Address - Country:US
Mailing Address - Phone:972-849-9682
Mailing Address - Fax:
Practice Address - Street 1:800 E CRINER ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:TX
Practice Address - Zip Code:76050-2231
Practice Address - Country:US
Practice Address - Phone:817-866-2315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty