Provider Demographics
NPI:1235285685
Name:HOLLAND DENTAL PRACTICE, PC
Entity Type:Organization
Organization Name:HOLLAND DENTAL PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-953-0553
Mailing Address - Street 1:295 BUCK RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1733
Mailing Address - Country:US
Mailing Address - Phone:215-953-0553
Mailing Address - Fax:
Practice Address - Street 1:295 BUCK RD
Practice Address - Street 2:SUITE 109
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-1733
Practice Address - Country:US
Practice Address - Phone:215-953-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023239L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental