Provider Demographics
NPI:1558479964
Name:HOLTGREIVE, JAMES FRANCIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:HOLTGREIVE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 S BURDICK ST
Mailing Address - Street 2:STE 220
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007
Mailing Address - Country:US
Mailing Address - Phone:269-345-7373
Mailing Address - Fax:269-345-8607
Practice Address - Street 1:321 S BURDICK ST
Practice Address - Street 2:STE 220
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007
Practice Address - Country:US
Practice Address - Phone:269-345-7373
Practice Address - Fax:269-345-8607
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010083211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice