Provider Demographics
NPI:1730673567
Name:HOLT, ELIZABETH R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:R
Last Name:HOLT
Suffix:
Gender:F
Credentials:DDS
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Other - Credentials:
Mailing Address - Street 1:NAVY MEDICINE READINESS & TRAINING UNIT SAN ANTONIO
Mailing Address - Street 2:3851 ROGER BROOKE DR. BLDG 15
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVY MEDICINE READINESS & TRAINING UNIT SAN ANTONIO
Practice Address - Street 2:3851 ROGER BROOKE DR BLDG 15
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:210-808-3735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001854-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist