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Organization
ALEXIS COLLINS CHILDRENS DENTISTRY
Active
Organization
ALEXIS COLLINS CHILDRENS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS COLLINS (OWNER)
(803) 772-7302
Entity
Organization
Contact information
Practice address
392 SAINT ANDREWS RD, COLUMBIA, SC 29210-4427
(803) 772-7302
(803) 772-7353
Mailing address
1774 DUTCH FORK RD, IRMO, SC 29063-8829
(803) 772-7302
(803) 772-7353
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4507
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z17072
—
SC
05
—
ZX4507
—
SC
Enumeration date
01/17/2012
Last updated
12/30/2022
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