Provider Demographics
NPI:1124125885
Name:COLLIER, ROBERT HARRIS (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HARRIS
Last Name:COLLIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BROADWAY RM 1310
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4365
Mailing Address - Country:US
Mailing Address - Phone:212-587-0202
Mailing Address - Fax:520-742-1311
Practice Address - Street 1:150 BROADWAY RM 1310
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4365
Practice Address - Country:US
Practice Address - Phone:212-587-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ28881223G0001X
NY041638-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice