Provider Demographics
NPI:1568574408
Name:BURNS, HOLLY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:52 ELM ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3489
Mailing Address - Country:US
Mailing Address - Phone:631-424-8818
Mailing Address - Fax:
Practice Address - Street 1:52 ELM ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3489
Practice Address - Country:US
Practice Address - Phone:631-424-8818
Practice Address - Fax:631-424-8819
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0454381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice