Individual
DR. SAMUEL DEON COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19404 MORRIS AVE, MANVEL, TX 77578
(404) 370-2510
Mailing address
19404 MORRIS AVE, MANVEL, TX 77578-3702
(404) 370-2510
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
28595
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
28595
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5620
MCNA
TX
Enumeration date
06/15/2006
Last updated
06/06/2023
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