Provider Demographics
NPI:1700856564
Name:GRIFFIN, HOLLY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:LYNN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6574
Mailing Address - Country:US
Mailing Address - Phone:301-977-9787
Mailing Address - Fax:301-977-0680
Practice Address - Street 1:308 MAIN ST
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6574
Practice Address - Country:US
Practice Address - Phone:301-977-9787
Practice Address - Fax:301-977-0680
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice