Provider Demographics
NPI:1588734917
Name:MCKINNEY, HOLLY HERTEL (DDS)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:HERTEL
Last Name:MCKINNEY
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 1:6317 PRESTON RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2676
Mailing Address - Country:US
Mailing Address - Phone:972-527-5555
Mailing Address - Fax:
Practice Address - Street 1:6317 PRESTON RD
Practice Address - Street 2:SUITE 500
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2676
Practice Address - Country:US
Practice Address - Phone:972-527-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001031632122300000X
TX250831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist