Provider Demographics
NPI:1396963542
Name:COLLINS, PATRICIA (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2958 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2126
Mailing Address - Country:US
Mailing Address - Phone:717-898-6068
Mailing Address - Fax:
Practice Address - Street 1:2958 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2126
Practice Address - Country:US
Practice Address - Phone:717-898-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-O21149-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice