Provider Demographics
NPI:1760479927
Name:COLLINS, PATRICK H (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:H
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 1:2321 SW OPOSSUM HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-5288
Mailing Address - Country:US
Mailing Address - Phone:816-229-0870
Mailing Address - Fax:
Practice Address - Street 1:1701 SW 40 HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-4621
Practice Address - Country:US
Practice Address - Phone:816-229-2442
Practice Address - Fax:816-229-0169
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO 126881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice