Individual
MARK ANTHONY COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3088 APPALACHIAN HWY STE 2, JACKSBORO, TN 37757-2526
(423) 566-8248
(423) 566-8247
Mailing address
3088 APPALACHIAN HWY STE 2, JACKSBORO, TN 37757-2526
(423) 566-8248
(423) 566-8247
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8223
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9176866T
—
TN
Enumeration date
07/26/2006
Last updated
07/09/2007
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