Provider Demographics
NPI:1891881835
Name:HOLVE, GREGORY W (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:W
Last Name:HOLVE
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 1:12156 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3829
Mailing Address - Country:US
Mailing Address - Phone:818-509-3055
Mailing Address - Fax:818-763-6159
Practice Address - Street 1:12156 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3829
Practice Address - Country:US
Practice Address - Phone:818-509-3055
Practice Address - Fax:818-763-6159
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice