Provider Demographics
NPI:1114353901
Name:HOLADAY, CINDA (RDH BS)
Entity Type:Individual
Prefix:
First Name:CINDA
Middle Name:
Last Name:HOLADAY
Suffix:
Gender:F
Credentials:RDH BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 S 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-7539
Mailing Address - Country:US
Mailing Address - Phone:541-953-2356
Mailing Address - Fax:
Practice Address - Street 1:1137 S 45TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-7539
Practice Address - Country:US
Practice Address - Phone:541-953-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2298124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist