Provider Demographics
NPI:1841637345
Name:SANTAGO, HOLLY LINN (DDS)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:LINN
Last Name:SANTAGO
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 1:1008 BIG OAK CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6566
Mailing Address - Country:US
Mailing Address - Phone:919-266-3380
Mailing Address - Fax:919-266-3319
Practice Address - Street 1:1008 BIG OAK CT
Practice Address - Street 2:SUITE C
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6566
Practice Address - Country:US
Practice Address - Phone:919-266-3380
Practice Address - Fax:919-266-3319
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9526122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist