Provider Demographics
NPI:1487802286
Name:COLLINS, ADAIRA JEVONNE (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAIRA
Middle Name:JEVONNE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 MERIDIAN ST N
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4636
Mailing Address - Country:US
Mailing Address - Phone:256-428-7276
Mailing Address - Fax:256-428-7259
Practice Address - Street 1:1110 MERIDIAN ST N
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4636
Practice Address - Country:US
Practice Address - Phone:256-428-7276
Practice Address - Fax:256-428-7259
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD56521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice