Provider Demographics
NPI:1760492201
Name:HOLLAND, MICHAEL LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LYNN
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 1:2332 HARRISON AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3287
Mailing Address - Country:US
Mailing Address - Phone:707-443-2348
Mailing Address - Fax:707-443-0684
Practice Address - Street 1:2332 HARRISON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3287
Practice Address - Country:US
Practice Address - Phone:707-443-2348
Practice Address - Fax:707-443-0684
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice