Provider Demographics
NPI:1730461948
Name:DINH, HOLLY (PHARMD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:DINH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13608 CASCATA STRADA
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5189
Mailing Address - Country:US
Mailing Address - Phone:405-735-3073
Mailing Address - Fax:
Practice Address - Street 1:4300 SE 29TH ST
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3312
Practice Address - Country:US
Practice Address - Phone:405-677-5519
Practice Address - Fax:405-677-7357
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist