Provider Demographics
NPI:1043651029
Name:CHRISTOPHER G. COLLINS D.M.D. L.L.C.
Entity type:Organization
Organization Name:CHRISTOPHER G. COLLINS D.M.D. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-229-4813
Mailing Address - Street 1:228 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-2412
Mailing Address - Country:US
Mailing Address - Phone:864-229-4813
Mailing Address - Fax:864-943-4358
Practice Address - Street 1:228 GRACE ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-2412
Practice Address - Country:US
Practice Address - Phone:864-229-4813
Practice Address - Fax:864-943-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty