Provider Demographics
NPI:1659875862
Name:ARNOLD, ALEXANDRA HOLLOWAY (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:HOLLOWAY
Last Name:ARNOLD
Suffix:
Gender:
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:PO BOX 5680
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-5680
Mailing Address - Country:US
Mailing Address - Phone:859-361-6610
Mailing Address - Fax:
Practice Address - Street 1:51 EAGLE RD # A1
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-5991
Practice Address - Country:US
Practice Address - Phone:970-479-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002049581223G0001X
SC9225390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223G0001XDental ProvidersDentistGeneral Practice