Individual
ROXANNE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
SR 571, 28, EL RITO, NM 87530
(505) 581-4728
Mailing address
PO BOX 237, EL RITO, NM 87530-0237
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D7559
OR
122300000X
Dentist
Primary
DD1955
NM
Other
Enumeration date
09/19/2005
Last updated
01/05/2012
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