Provider Demographics
NPI:1730790122
Name:COLLINS, CURTIS WADE (DDS)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:WADE
Last Name:COLLINS
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 1:507 COLLEGE AVE N
Mailing Address - Street 2:
Mailing Address - City:WESSINGTON SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57382-2021
Mailing Address - Country:US
Mailing Address - Phone:308-520-7177
Mailing Address - Fax:
Practice Address - Street 1:602 1ST ST NE STE 2
Practice Address - Street 2:
Practice Address - City:WESSINGTON SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57382-2163
Practice Address - Country:US
Practice Address - Phone:605-539-1981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD1284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist