Provider Demographics
NPI:1497076418
Name:HOLSINGER, DANIEL MARK (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARK
Last Name:HOLSINGER
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 SEABOARD LN STE 102
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3037
Mailing Address - Country:US
Mailing Address - Phone:615-377-3080
Mailing Address - Fax:615-377-3088
Practice Address - Street 1:95 SEABOARD LN STE 102
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3037
Practice Address - Country:US
Practice Address - Phone:615-377-3080
Practice Address - Fax:615-377-3088
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN92781223P0221X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ014908Medicaid