Provider Demographics
NPI:1992969539
Name:HOLMBERG-SPINK, ANN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:HOLMBERG-SPINK
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 1:1012 WOODSIDE LN
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-8613
Mailing Address - Country:US
Mailing Address - Phone:360-221-8785
Mailing Address - Fax:360-221-8786
Practice Address - Street 1:1012 WOODSIDE LN
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-8613
Practice Address - Country:US
Practice Address - Phone:360-221-8785
Practice Address - Fax:360-221-8786
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA 6979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist