Provider Demographics
NPI:1083720700
Name:TOMAS E. HOLBROOK DDS PS
Entity Type:Organization
Organization Name:TOMAS E. HOLBROOK DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-457-4532
Mailing Address - Street 1:11 N 11TH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3085
Mailing Address - Country:US
Mailing Address - Phone:509-457-4532
Mailing Address - Fax:509-453-0175
Practice Address - Street 1:11 N 11TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3085
Practice Address - Country:US
Practice Address - Phone:509-457-4532
Practice Address - Fax:509-453-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5434261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental