Provider Demographics
NPI:1790098606
Name:HOLMAN, BRET J (DDS)
Entity Type:Individual
Prefix:
First Name:BRET
Middle Name:J
Last Name:HOLMAN
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 1:382 S BLUFF ST STE 250
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3672
Mailing Address - Country:US
Mailing Address - Phone:435-656-1111
Mailing Address - Fax:
Practice Address - Street 1:382 S BLUFF ST STE 250
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3672
Practice Address - Country:US
Practice Address - Phone:435-656-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS606551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice