Organization
DR. SEAN M. COLLINS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN COLLINS D.D.S., M.S.D (OWNER)
(209) 367-3595
Entity
Organization
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
02/18/2010
Last updated
02/18/2010
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