Individual
DR. JOHN MICHAEL COLLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1521 NORTHWAY DR, SUITE 108, SAINT CLOUD, MN 56303-4489
(320) 253-8380
(320) 253-8419
Mailing address
1521 NORTHWAY DR, SUITE 108, SAINT CLOUD, MN 56303-4489
(320) 253-8380
(320) 253-8419
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7903
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54195CO
BLUE CROSS BLUE SHIELD
MN
01
—
7903
DENTAL LICENSE
MN
Enumeration date
07/26/2006
Last updated
07/09/2007
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