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General NPI Number Information
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NPI Number | 1740482744
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Entity Type | Organization
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Legal Business Name | JOY HOLLINSHEAD DDS PC
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 109 3RD STREET WEST
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City | HALSTAD
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State | MN
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Zip | 56548
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Country | US
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Telephone | 218-456-2182
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Fax | 218-456-2382
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Provider Business Mailing Address
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Address Line | 109 3RD STREET WEST BOX 119
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City | HALSTAD
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State | MN
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Zip | 56548
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Country | US
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Telephone | 218-456-2182
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Fax | 218-456-2382
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. JOYCE C HOLLINSHEAD
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Credential | DDS
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Telephone | 218-456-2182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D11115
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License Number State | MN
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