Provider Demographics
NPI:1295939320
Name:D. WAYNE HOLLAR, JR., DDS, PA
Entity type:Organization
Organization Name:D. WAYNE HOLLAR, JR., DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-754-6251
Mailing Address - Street 1:614 HOSPITAL AVE NW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-4307
Mailing Address - Country:US
Mailing Address - Phone:828-754-6251
Mailing Address - Fax:
Practice Address - Street 1:614 HOSPITAL AVE NW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-4307
Practice Address - Country:US
Practice Address - Phone:828-754-6251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty