Provider Demographics
NPI:1679976013
Name:CRAIG B HOLLINGSWORTH DDS INC
Entity type:Organization
Organization Name:CRAIG B HOLLINGSWORTH DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOLLINGSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-452-5231
Mailing Address - Street 1:2650 21ST ST. #7
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-2539
Mailing Address - Country:US
Mailing Address - Phone:916-452-5231
Mailing Address - Fax:916-452-5294
Practice Address - Street 1:2650 21ST ST. #7
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2539
Practice Address - Country:US
Practice Address - Phone:916-452-5231
Practice Address - Fax:916-452-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA244601223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty