| Dr. Sean M. Collins | |
|
630 S Fairmont Ave Ste B Lodi CA 95240-3803 | |
| (209) 367-3595 | |
| (209) 367-9276 |
| Full Name | Dr. Sean M. Collins |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 630 S Fairmont Ave Ste B, Lodi, California |
| Authorized Official Name and Position | Sean Collins (OWNER) |
| Authorized Official Contact | 2093673595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Sean M. Collins 630 S Fairmont Ave Ste B Lodi CA 95240-3803 Ph: (209) 367-3595 | Dr. Sean M. Collins 630 S Fairmont Ave Ste B Lodi CA 95240-3803 Ph: (209) 367-3595 |
| NPI Number | 1578885471 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578885471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 36740 (California) | Primary |
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