Provider Demographics
NPI:1285030148
Name:SAMUEL J. HOLCROFT, DMD.PA
Entity Type:Organization
Organization Name:SAMUEL J. HOLCROFT, DMD.PA
Other - Org Name:HOLCROFT AND FAIGEN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOLCROFT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-622-5600
Mailing Address - Street 1:2560 RCA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3338
Mailing Address - Country:US
Mailing Address - Phone:561-622-5600
Mailing Address - Fax:561-622-5601
Practice Address - Street 1:2560 RCA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3338
Practice Address - Country:US
Practice Address - Phone:561-622-5600
Practice Address - Fax:561-622-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL159001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty