Provider Demographics
NPI:1659875862
Name:ARNOLD, ALEXANDRA HOLLOWAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:HOLLOWAY
Last Name:ARNOLD
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 1:920 GREENE ST APT 103
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2273
Mailing Address - Country:US
Mailing Address - Phone:859-361-6610
Mailing Address - Fax:
Practice Address - Street 1:109 ANDREW AVE STE 202
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-3157
Practice Address - Country:US
Practice Address - Phone:508-358-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18583431223G0001X
SC9225390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223G0001XDental ProvidersDentistGeneral Practice