Provider Demographics
NPI:1295095198
Name:MAYHER, HOLLY VIRGINIA (DDS)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:VIRGINIA
Last Name:MAYHER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:GUARD
Other - Last Name:MAYHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:101 RIDGELY AVE STE 22A
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1416
Mailing Address - Country:US
Mailing Address - Phone:410-268-5751
Mailing Address - Fax:410-267-7044
Practice Address - Street 1:101 RIDGELY AVE STE 22A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1416
Practice Address - Country:US
Practice Address - Phone:410-268-5751
Practice Address - Fax:410-267-7044
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice