Provider Demographics
NPI:1275794604
Name:GARY M HOLT D.D.S., P.C.
Entity Type:Organization
Organization Name:GARY M HOLT D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-798-0928
Mailing Address - Street 1:7889 S LINCOLN CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2651
Mailing Address - Country:US
Mailing Address - Phone:303-798-0928
Mailing Address - Fax:303-798-2531
Practice Address - Street 1:7889 S LINCOLN CT
Practice Address - Street 2:SUITE 102
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2651
Practice Address - Country:US
Practice Address - Phone:303-798-0928
Practice Address - Fax:303-798-2531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty