Provider Demographics
NPI:1588830517
Name:SLETTEN, HOLLY BOWSER (DMD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:BOWSER
Last Name:SLETTEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:GRETCHEN
Other - Last Name:BOWSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:10371 PARKGLENN WAY
Mailing Address - Street 2:SUITE 175
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3885
Mailing Address - Country:US
Mailing Address - Phone:720-851-1676
Mailing Address - Fax:720-851-0692
Practice Address - Street 1:10371 PARKGLENN WAY
Practice Address - Street 2:SUITE 175
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3885
Practice Address - Country:US
Practice Address - Phone:720-851-1676
Practice Address - Fax:720-851-0692
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO91951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice