Provider Demographics
NPI:1699260448
Name:VALENTINA HOLINA, DMD, A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:VALENTINA HOLINA, DMD, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALENTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-983-8360
Mailing Address - Street 1:4726 SALEM WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2235
Mailing Address - Country:US
Mailing Address - Phone:916-690-0380
Mailing Address - Fax:
Practice Address - Street 1:100 IRON POINT CIR STE 102
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8596
Practice Address - Country:US
Practice Address - Phone:916-983-8360
Practice Address - Fax:916-983-8365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60740261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental