Provider Demographics
NPI:1124486493
Name:ANDREA C. MULHOLLAND, DDS INC.
Entity type:Organization
Organization Name:ANDREA C. MULHOLLAND, DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:MULHOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-228-4850
Mailing Address - Street 1:601 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1025
Mailing Address - Country:US
Mailing Address - Phone:614-228-4850
Mailing Address - Fax:614-228-4668
Practice Address - Street 1:601 S 3RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-1025
Practice Address - Country:US
Practice Address - Phone:614-228-4850
Practice Address - Fax:614-228-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0-21257122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty