Provider Demographics
NPI:1770600926
Name:COLLINS, JEFFREY M (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:COLLINS
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 1:1054 CAMELLIA CT
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-5140
Mailing Address - Country:US
Mailing Address - Phone:775-782-2642
Mailing Address - Fax:775-783-9211
Practice Address - Street 1:1054 CAMELLIA CT
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-5140
Practice Address - Country:US
Practice Address - Phone:775-782-2642
Practice Address - Fax:775-783-9211
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist