Provider Demographics
NPI:1174647051
Name:HOLTKAMP, GREGG B (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:B
Last Name:HOLTKAMP
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 1:7770 COOPER RD
Mailing Address - Street 2:STE. 6
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7744
Mailing Address - Country:US
Mailing Address - Phone:513-984-2220
Mailing Address - Fax:513-984-2273
Practice Address - Street 1:7770 COOPER RD
Practice Address - Street 2:STE. 6
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7744
Practice Address - Country:US
Practice Address - Phone:513-984-2220
Practice Address - Fax:513-984-2273
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice