Provider Demographics
NPI:1841427754
Name:HOLWAGER, LINEL DENISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINEL
Middle Name:DENISE
Last Name:HOLWAGER
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 1:1919 ELIZABETHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-8100
Mailing Address - Country:US
Mailing Address - Phone:270-259-3232
Mailing Address - Fax:
Practice Address - Street 1:1919 ELIZABETHTOWN RD
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-8100
Practice Address - Country:US
Practice Address - Phone:270-259-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87801223G0001X
IN12011354A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice