Provider Demographics
NPI:1295092278
Name:ANA MARIA T COLLANTES, DDS INC
Entity type:Organization
Organization Name:ANA MARIA T COLLANTES, DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:COLLANTES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-945-2645
Mailing Address - Street 1:44810 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3106
Mailing Address - Country:US
Mailing Address - Phone:661-945-2645
Mailing Address - Fax:
Practice Address - Street 1:44810 ELM AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3106
Practice Address - Country:US
Practice Address - Phone:661-945-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty