Individual
DR. CLIFFORD CHARLES COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
215 W ASHLAND AVE, INDIANOLA, IA 50125-2422
(515) 961-8186
Mailing address
1905 FAIRWAY DR, INDIANOLA, IA 50125-1070
(515) 962-2001
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5937
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099390
—
IA
Enumeration date
04/26/2007
Last updated
07/08/2007
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