Provider Demographics
NPI:1891818456
Name:HOLT, JEFFREY D (DDS)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:D
Last Name:HOLT
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 1:4112 N JOSEY LN STE 128
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1529
Mailing Address - Country:US
Mailing Address - Phone:972-394-2140
Mailing Address - Fax:972-394-6489
Practice Address - Street 1:4112 N JOSEY LN STE 128
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1529
Practice Address - Country:US
Practice Address - Phone:972-394-2140
Practice Address - Fax:972-394-6489
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry