Provider Demographics
NPI:1205174406
Name:ARNOLD, HOLLY ANNE (RDH)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ANNE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 ASH MEADOWS RD
Mailing Address - Street 2:APARTMENT #1017
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-4057
Mailing Address - Country:US
Mailing Address - Phone:509-551-6058
Mailing Address - Fax:
Practice Address - Street 1:4755 LIBERTY RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5077
Practice Address - Country:US
Practice Address - Phone:503-363-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6337124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist