Provider Demographics
NPI:1487964789
Name:COLLINS, JAMES HUNTER (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HUNTER
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:HUNTER
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:524 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2524
Mailing Address - Country:US
Mailing Address - Phone:321-725-6565
Mailing Address - Fax:321-722-3871
Practice Address - Street 1:524 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32951-2524
Practice Address - Country:US
Practice Address - Phone:321-725-6565
Practice Address - Fax:321-722-3871
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN142751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice