Individual
RAYMOND F COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 BLUE HOLE DRIVE, SANTA ROSA, NM 88435-2533
(505) 718-6899
Mailing address
1000 BLUE HOLE RD, SANTA ROSA, NM 88435-2533
(505) 718-6899
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2469
NM
1223G0001X
General Practice Dentistry
6443
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47071268402
—
NE
01
—
5487
BCBS PROVIDER ID
NE
Enumeration date
12/01/2005
Last updated
09/11/2025
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