Provider Demographics
NPI:1346425691
Name:ROBERT L. HOLLOWELL III DDS MSD PLLC
Entity Type:Organization
Organization Name:ROBERT L. HOLLOWELL III DDS MSD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLLOWELL
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS MSD PPLC
Authorized Official - Phone:919-570-2872
Mailing Address - Street 1:2824 ROGERS ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-0000
Mailing Address - Country:US
Mailing Address - Phone:919-570-2872
Mailing Address - Fax:
Practice Address - Street 1:2824 ROGERS ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-0000
Practice Address - Country:US
Practice Address - Phone:919-570-2872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty