Provider Demographics
NPI:1902924749
Name:ANDREW P. COLLINS, DMD, PA
Entity Type:Organization
Organization Name:ANDREW P. COLLINS, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PICKENS
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-599-3848
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-1237
Mailing Address - Country:US
Mailing Address - Phone:336-599-3848
Mailing Address - Fax:336-599-2953
Practice Address - Street 1:441 S MORGAN ST
Practice Address - Street 2:SUITE C.
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5123
Practice Address - Country:US
Practice Address - Phone:336-599-3848
Practice Address - Fax:336-599-2953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty