Provider Demographics
NPI:1912991779
Name:HOLSTEEN, DANIEL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:HOLSTEEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 GARDEN OF THE GODS RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3436
Mailing Address - Country:US
Mailing Address - Phone:719-598-3502
Mailing Address - Fax:719-598-9264
Practice Address - Street 1:1045 GARDEN OF THE GODS RD
Practice Address - Street 2:SUITE N
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3436
Practice Address - Country:US
Practice Address - Phone:719-598-3502
Practice Address - Fax:719-598-9264
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1053761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice