Individual
DR. JEFFREY LEE HOLLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1288 MORRO ST STE 110, SAN LUIS OBISPO, CA 93401-6303
(805) 549-0380
(805) 547-7084
Mailing address
1288 MORRO ST STE 110, SAN LUIS OBISPO, CA 93401-6303
(805) 549-0380
(805) 547-7084
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
40156
CA
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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