Individual
DR. THOMAS A COLLINS JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1103 E MONTCLAIR ST, SUITE 100, SPRINGFIELD, MO 65807-5076
(417) 887-8800
(417) 887-6265
Mailing address
1103 E MONTCLAIR ST, SUITE 100, SPRINGFIELD, MO 65807-5076
(417) 887-8800
(417) 887-6265
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
015066
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11922
BC/S DENTAL
—
01
—
15055
DELTA
—
01
—
15440
BC/S MEDICAL
—
01
—
159046
UNITED CONCORDIA
—
Enumeration date
09/20/2005
Last updated
07/08/2007
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