Individual
DR. GORDON BLAKE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
950 LANEY WALKER BLVD, RICHMOND COUNTY HEALTH DEPT, AUGUSTA, GA 30901
(706) 721-5891
(706) 721-5898
Mailing address
950 LANEY WALKER BLVD, RICHMOND COUNTY HEALTH DEPT, AUGUSTA, GA 30901
(706) 721-5891
(706) 721-5898
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN011479
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9184628
DORAL
GA
Enumeration date
10/25/2006
Last updated
07/08/2007
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