Provider Demographics
NPI:1710281274
Name:HOLLAND, JAMES RANDALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RANDALL
Last Name:HOLLAND
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 1:1970 E WHIPPOORWILL LN
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-8415
Mailing Address - Country:US
Mailing Address - Phone:580-889-6651
Mailing Address - Fax:580-889-9163
Practice Address - Street 1:1970 E WHIPPOORWILL LN
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-8415
Practice Address - Country:US
Practice Address - Phone:580-889-6651
Practice Address - Fax:580-889-9163
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5525122300000X
TX13094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist