Provider Demographics
NPI:1396368346
Name:KOBERLEIN, HOLLIE CHRISTINE (DMD)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:CHRISTINE
Last Name:KOBERLEIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 AMBERLEY DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6961
Mailing Address - Country:US
Mailing Address - Phone:330-388-1824
Mailing Address - Fax:
Practice Address - Street 1:1837 STEESE RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9555
Practice Address - Country:US
Practice Address - Phone:330-899-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0261511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice