Provider Demographics
NPI:1295078582
Name:HOLDA, JOHN M (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:HOLDA
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 1:30 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5426
Mailing Address - Country:US
Mailing Address - Phone:973-228-3422
Mailing Address - Fax:
Practice Address - Street 1:30 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5426
Practice Address - Country:US
Practice Address - Phone:973-228-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0086451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice