Provider Demographics
NPI:1598145088
Name:HOLZER, KATHRYN ANN (DDS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:HOLZER
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 1:115 W CENTURY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1403
Mailing Address - Country:US
Mailing Address - Phone:701-222-8229
Mailing Address - Fax:701-258-7828
Practice Address - Street 1:115 W CENTURY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1403
Practice Address - Country:US
Practice Address - Phone:701-222-8229
Practice Address - Fax:701-258-7828
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND22551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice