Provider Demographics
NPI:1609948272
Name:HOLPUCH, KIEFER DDS AND ASSOCIATES INC.
Entity Type:Organization
Organization Name:HOLPUCH, KIEFER DDS AND ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:KIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-872-5771
Mailing Address - Street 1:340 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-1265
Mailing Address - Country:US
Mailing Address - Phone:330-872-5771
Mailing Address - Fax:330-872-1680
Practice Address - Street 1:340 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1265
Practice Address - Country:US
Practice Address - Phone:330-872-5771
Practice Address - Fax:330-872-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty