Individual
DR. JOHN DAVID COLLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3950 VETERANS DRIVE, SUITE 102, ST. CLOUD, MN 56303
(320) 253-8380
(320) 253-8419
Mailing address
3950 VETERANS DRIVE, SUITE 102, ST. CLOUD, MN 56303
(320) 253-8380
(320) 253-8419
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
11694
MN
1223P0221X
Pediatric Dentistry
Primary
D11694
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11694
DENTAL LICENSE
MN
05
—
839677900
—
MN
01
—
D11694
LICENSE
MN
Enumeration date
07/26/2006
Last updated
12/06/2023
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