Provider Demographics
NPI:1679677876
Name:HOLMES, JOHN E (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:HOLMES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2130
Mailing Address - Country:US
Mailing Address - Phone:816-322-3506
Mailing Address - Fax:816-322-3506
Practice Address - Street 1:1731 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012
Practice Address - Country:US
Practice Address - Phone:816-322-3506
Practice Address - Fax:816-322-3506
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX258551223G0001X
MO112351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice