Provider Demographics
NPI:1053961169
Name:HOLOWNIA, NICOLE ARYN (DDS)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ARYN
Last Name:HOLOWNIA
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 1:6040 MAIN ST STE 152
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1391
Mailing Address - Country:US
Mailing Address - Phone:925-719-1704
Mailing Address - Fax:
Practice Address - Street 1:6040 MAIN ST STE 152
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1391
Practice Address - Country:US
Practice Address - Phone:707-552-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1043121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice