Provider Demographics
NPI:1477168102
Name:PASCHKE, HOLLIE CATHLEEN (DMD)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:CATHLEEN
Last Name:PASCHKE
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 1:3800 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2361
Mailing Address - Country:US
Mailing Address - Phone:941-927-5411
Mailing Address - Fax:
Practice Address - Street 1:3800 CLARK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2361
Practice Address - Country:US
Practice Address - Phone:941-927-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist