Provider Demographics
NPI:1891133971
Name:HOLLENBECK, DANA J (DDS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:J
Last Name:HOLLENBECK
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 1:271 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8622
Mailing Address - Country:US
Mailing Address - Phone:260-615-6720
Mailing Address - Fax:
Practice Address - Street 1:2692 S STRAITS HWY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-9792
Practice Address - Country:US
Practice Address - Phone:231-238-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020978122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist