Provider Demographics
NPI:1538336771
Name:HOLMAN, RONALD E (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25520 STATE ROAD 46
Mailing Address - Street 2:
Mailing Address - City:SORRENTO
Mailing Address - State:FL
Mailing Address - Zip Code:32776-9526
Mailing Address - Country:US
Mailing Address - Phone:352-735-2211
Mailing Address - Fax:352-735-5844
Practice Address - Street 1:25520 STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:SORRENTO
Practice Address - State:FL
Practice Address - Zip Code:32776-9526
Practice Address - Country:US
Practice Address - Phone:352-735-2211
Practice Address - Fax:352-735-5844
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1174565881OtherNATIONAL PROVIDER IDENTIFIER (PRACTICE)