Provider Demographics
NPI:1992996755
Name:HOLCROFT, SAMUEL JOSEPH (DMD, PA)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:HOLCROFT
Suffix:
Gender:M
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 RCA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3338
Mailing Address - Country:US
Mailing Address - Phone:561-622-5600
Mailing Address - Fax:561-622-5601
Practice Address - Street 1:2560 RCA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3338
Practice Address - Country:US
Practice Address - Phone:561-622-5600
Practice Address - Fax:561-622-5601
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL159001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice