Richard J. Collis, D.D.S. Valid NPI
Individual provider · General Practice Dentistry · Hermosa Beach, CA
- NPI
- 1801010632
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 21106 (CA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2007-04-12
- Last updated
- 2007-07-08
Practice location
2401 Pacific Coast Highway, Suite 205
Hermosa Beach, CA 90254-2735
(310) 374-8901