Provider Demographics
NPI:1023205663
Name:HOLBROOK, VON JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:VON
Middle Name:JOSEPH
Last Name:HOLBROOK
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 1:88 N OAK ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-5686
Mailing Address - Country:US
Mailing Address - Phone:805-643-5026
Mailing Address - Fax:805-643-5029
Practice Address - Street 1:88 N OAK ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-5686
Practice Address - Country:US
Practice Address - Phone:805-643-5026
Practice Address - Fax:805-643-5029
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist