Provider Demographics
NPI:1720049570
Name:COLLIER, LAURA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:S
Last Name:COLLIER
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 1:348 2ND STREET SUITE #200
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331
Mailing Address - Country:US
Mailing Address - Phone:952-474-6515
Mailing Address - Fax:952-474-1206
Practice Address - Street 1:348 2ND STREET, SUITE #200
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331
Practice Address - Country:US
Practice Address - Phone:952-474-6515
Practice Address - Fax:952-474-1206
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist