Provider Demographics
NPI:1841578820
Name:HOLINBECK, UDOKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:UDOKA
Middle Name:
Last Name:HOLINBECK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N35W23770 CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-6312
Mailing Address - Country:US
Mailing Address - Phone:262-691-4555
Mailing Address - Fax:262-691-4579
Practice Address - Street 1:N35W23770 CAPITOL DR
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-6312
Practice Address - Country:US
Practice Address - Phone:262-691-4555
Practice Address - Fax:262-691-4579
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272701223G0001X
WI1001128-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist