Provider Demographics
NPI:1093851354
Name:HOILAND, JAIMIE NICOLE (DDS)
Entity Type:Individual
Prefix:
First Name:JAIMIE
Middle Name:NICOLE
Last Name:HOILAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JAIMIE
Other - Middle Name:NICOLE
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 SHERIDAN AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412
Mailing Address - Country:US
Mailing Address - Phone:612-710-2113
Mailing Address - Fax:
Practice Address - Street 1:13551 BALSAM LANE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:MN
Practice Address - Zip Code:55327
Practice Address - Country:US
Practice Address - Phone:763-422-1714
Practice Address - Fax:763-712-5754
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND122701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice