Provider Demographics
NPI:1134291669
Name:HOLLINSHEAD, JOYCE CLAIRE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:CLAIRE
Last Name:HOLLINSHEAD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:JOYCE
Other - Middle Name:CLAIRE
Other - Last Name:HOLLINSHEAD SUDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:HALSTAD
Mailing Address - State:MN
Mailing Address - Zip Code:56548-0119
Mailing Address - Country:US
Mailing Address - Phone:218-456-2182
Mailing Address - Fax:
Practice Address - Street 1:109 3RD ST WEST
Practice Address - Street 2:
Practice Address - City:HALSTAD
Practice Address - State:MN
Practice Address - Zip Code:56548
Practice Address - Country:US
Practice Address - Phone:218-456-2182
Practice Address - Fax:218-456-2382
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11115122300000X
ND2451122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist