Provider Demographics
NPI:1407059785
Name:MAIER, HOLLY BETH (DMD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:BETH
Last Name:MAIER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:BETH
Other - Last Name:MAIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:303 HARVEY FARM RD
Mailing Address - Street 2:
Mailing Address - City:WATERBURY CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05677-7123
Mailing Address - Country:US
Mailing Address - Phone:860-272-1519
Mailing Address - Fax:
Practice Address - Street 1:77 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1555
Practice Address - Country:US
Practice Address - Phone:802-244-6366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009729122300000X
VT016-0002244122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist