Provider Demographics
NPI:1326291048
Name:HOLLINGSWORTH, TONETTE LEE (RDH)
Entity Type:Individual
Prefix:
First Name:TONETTE
Middle Name:LEE
Last Name:HOLLINGSWORTH
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 1:503 W GALENA ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1607
Mailing Address - Country:US
Mailing Address - Phone:406-723-8286
Mailing Address - Fax:
Practice Address - Street 1:503 W GALENA ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1607
Practice Address - Country:US
Practice Address - Phone:406-723-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT939124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist