Provider Demographics
NPI:1619033834
Name:HOLLIDAY, PAUL MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:HOLLIDAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:537 MARKET ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-1225
Mailing Address - Country:US
Mailing Address - Phone:423-756-4448
Mailing Address - Fax:423-756-4450
Practice Address - Street 1:537 MARKET ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-1225
Practice Address - Country:US
Practice Address - Phone:423-756-4448
Practice Address - Fax:423-756-4450
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN81021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice