| R. Charlie And Ute J Collins Dds, Pllc | |
|
1210 Roosevelt Ave Mount Vernon WA 98273-2425 | |
| (360) 424-5650 | |
| (360) 424-9672 |
| Full Name | R. Charlie And Ute J Collins Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1210 Roosevelt Ave, Mount Vernon, Washington |
| Authorized Official Name and Position | Ute J Collins (OWNER) |
| Authorized Official Contact | 3604245650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R. Charlie And Ute J Collins Dds, Pllc 1210 Roosevelt Ave Mount Vernon WA 98273-2425 Ph: (360) 424-5650 | R. Charlie And Ute J Collins Dds, Pllc 1210 Roosevelt Ave Mount Vernon WA 98273-2425 Ph: (360) 424-5650 |
| NPI Number | 1619199841 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619199841 | NPI | - | NPPES |
| 10103 | Other | WA | WA STATE LICENSE |
| 5050042 | Medicaid | WA | |
| $$$$$$$$$ | Other | WA | SSN |
| 1235192907 | Other | WA | INDIVIDUAL NPI |
| 1863209 | Other | WA | UNITED CONCORDIA ID |
| 5050471 | Medicaid | WA | |
| 602 548 356 | Other | WA | UBI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10103 (Washington) | Primary |
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