Provider Demographics
NPI:1689685950
Name:HOLLER, CATO OLIVER JR (DDS)
Entity Type:Individual
Prefix:
First Name:CATO
Middle Name:OLIVER
Last Name:HOLLER
Suffix:JR
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 1:212 EAST MAIN STREET
Mailing Address - Street 2:PO BOX 100
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762
Mailing Address - Country:US
Mailing Address - Phone:828-668-4128
Mailing Address - Fax:
Practice Address - Street 1:212 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:OLD FORT
Practice Address - State:NC
Practice Address - Zip Code:28762
Practice Address - Country:US
Practice Address - Phone:828-668-4128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice