Provider Demographics
NPI:1043523608
Name:HOLDEN FACIAL PLASTIC SURGERY A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HOLDEN FACIAL PLASTIC SURGERY A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-457-5700
Mailing Address - Street 1:9522 E SAN SALVADOR DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5557
Mailing Address - Country:US
Mailing Address - Phone:602-457-5700
Mailing Address - Fax:602-457-5708
Practice Address - Street 1:9522 E SAN SALVADOR DR
Practice Address - Street 2:SUITE 301
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5557
Practice Address - Country:US
Practice Address - Phone:602-457-5700
Practice Address - Fax:602-457-5708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43170207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty