Provider Demographics
NPI:1316942287
Name:HOLDREN, ROSE STEWART (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSE
Middle Name:STEWART
Last Name:HOLDREN
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 1:1344 NE MCWILLIAMS RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-3164
Mailing Address - Country:US
Mailing Address - Phone:360-662-1450
Mailing Address - Fax:360-662-1454
Practice Address - Street 1:1344 NE MCWILLIAMS RD
Practice Address - Street 2:SUITE 140
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-3164
Practice Address - Country:US
Practice Address - Phone:360-662-1450
Practice Address - Fax:360-662-1454
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist