Individual
DR. DAVID C COLLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
612 LOCUST ST, SUITE #2, DES MOINES, IA 50309-3718
(515) 280-3030
Mailing address
612 LOCUST ST, SUITE #2, DES MOINES, IA 50309-3718
(515) 280-3030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6370
IA
1223G0001X
General Practice Dentistry
Primary
6370
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159525
DELTA DENTAL ID#
IA
05
—
0159525
—
IA
01
—
42-1242080
FEDERAL TAX ID#
—
01
—
6370
IOWA LICENSE NUMBER
IA
Enumeration date
10/16/2006
Last updated
05/14/2008
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