Individual
DR. THERESA M. COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2058 S DOBSON RD, STE 12, MESA, AZ 85202-6454
(503) 267-7559
Mailing address
2058 S DOBSON RD, STE 12, MESA, AZ 85202-6454
(503) 267-7559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009063
AZ
1223G0001X
General Practice Dentistry
D9756
OR
Other
Enumeration date
07/25/2012
Last updated
08/04/2016
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