Organization
FORT MOHAVE DENTAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALAN COLLINS DDS (OWNER)
(928) 758-8887
Entity
Organization
Contact information
Practice address
1501 E CAMP MOHAVE RD # 1, FORT MOHAVE, AZ 86426-9406
(928) 758-8887
Mailing address
1501 E CAMP MOHAVE RD # 1, FORT MOHAVE, AZ 86426-9406
(928) 758-8887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4792
AZ
Other
Enumeration date
04/28/2008
Last updated
03/27/2012
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