Provider Demographics
NPI:1790271724
Name:HOLTSMASTER, DAWN (RDH, PHDHP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:HOLTSMASTER
Suffix:
Gender:F
Credentials:RDH, PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 APPLE TREE RD
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-8612
Mailing Address - Country:US
Mailing Address - Phone:570-778-5444
Mailing Address - Fax:
Practice Address - Street 1:903 APPLE TREE RD
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-8612
Practice Address - Country:US
Practice Address - Phone:570-778-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH069451124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist