Provider Demographics
NPI:1891355988
Name:HOLT, JOSHUA ROBERT (DMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ROBERT
Last Name:HOLT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 AVANTA WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6874
Mailing Address - Country:US
Mailing Address - Phone:406-702-1303
Mailing Address - Fax:
Practice Address - Street 1:10 AVANTA WAY STE 3
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6874
Practice Address - Country:US
Practice Address - Phone:406-702-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-173601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice