Provider Demographics
NPI:1669841953
Name:G. CHRIS HOLDAWAY, DDS, II, PA
Entity Type:Organization
Organization Name:G. CHRIS HOLDAWAY, DDS, II, PA
Other - Org Name:DENTON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAYLAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLDAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-509-0278
Mailing Address - Street 1:PO BOX 1440
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27239-1440
Mailing Address - Country:US
Mailing Address - Phone:336-859-4581
Mailing Address - Fax:
Practice Address - Street 1:49 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:NC
Practice Address - Zip Code:27239-6524
Practice Address - Country:US
Practice Address - Phone:336-859-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty