Provider Demographics
NPI:1013160993
Name:HOLLINGSWORTH, ROBERT H (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:HOLLINGSWORTH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 OSTER DR
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-8726
Mailing Address - Country:US
Mailing Address - Phone:859-748-0563
Mailing Address - Fax:
Practice Address - Street 1:1183 STANFORD ROAD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:KY
Practice Address - Zip Code:40444
Practice Address - Country:US
Practice Address - Phone:859-792-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice