Individual
SEAN MARTIN COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D
Contact information
Practice address
630 S FAIRMONT AVE STE B, LODI, CA 95240-3803
(209) 367-3595
(209) 367-9276
Mailing address
630 S FAIRMONT AVE STE B, LODI, CA 95240-3803
(209) 367-3595
(209) 367-9276
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
36740
CA
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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