Provider Demographics
NPI:1225446651
Name:HOLLAND, LAUREN (RDH)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 50TH ST NW APT 4
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-8218
Mailing Address - Country:US
Mailing Address - Phone:507-244-0771
Mailing Address - Fax:
Practice Address - Street 1:903 W CENTER ST STE 208
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-6278
Practice Address - Country:US
Practice Address - Phone:507-529-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH9131124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist