Provider Demographics
NPI:1861832834
Name:WINTERHOLLER, CODY WARNER (DDS)
Entity type:Individual
Prefix:DR
First Name:CODY
Middle Name:WARNER
Last Name:WINTERHOLLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 LARCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-4741
Mailing Address - Country:US
Mailing Address - Phone:406-672-0224
Mailing Address - Fax:
Practice Address - Street 1:413 SE 4TH ST
Practice Address - Street 2:WINTERHOLLER DENTISTRY
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-3317
Practice Address - Country:US
Practice Address - Phone:406-628-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-04
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7111122300000X
IA09076122300000X
MT9555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist