Organization
K.O.A.L.A. DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID COLLIER DDS (OWNER)
(320) 253-8380
Entity
Organization
Contact information
Practice address
1521 NORTHWAY DR, SUITE 108, SAINT CLOUD, MN 56303-4489
(320) 253-8380
(320) 253-8419
Mailing address
20 1ST AVE S, BUFFALO, MN 55313-1409
(320) 253-8380
(320) 253-8419
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D11694
MN
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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