Individual
DR. KENNETH RAY COLLINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 CARNEGIE PL, SUITE 108, FAYETTEVILLE, GA 30214-3905
(770) 461-0188
(770) 461-0488
Mailing address
100 CARNEGIE PL, SUITE 108, FAYETTEVILLE, GA 30214-3905
(770) 461-0188
(770) 461-0488
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
012476
GA
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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