Provider Demographics
NPI:1457763377
Name:HOLLOWAY, MCKENZIE WILLIAMS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MCKENZIE
Middle Name:WILLIAMS
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 PALMETTO RD. SUITE #C
Mailing Address - Street 2:4670 PALMETTO RD
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006
Mailing Address - Country:US
Mailing Address - Phone:318-965-5700
Mailing Address - Fax:318-965-5005
Practice Address - Street 1:3301 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7657
Practice Address - Country:US
Practice Address - Phone:504-833-6825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6465122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist